Organization Active NPI

Moshe H Shirazi MD PLLC

  • Internal Medicine Physician
  • Plainview, NY
National Provider Identifier
1174707251
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
196396 Issued in NY
Legal business name
MOSHE H SHIRAZI MD PLLC
Practice address
700 Old Country Rd
Suite 202
Plainview, NY 11803
Phone
(516) 433-4828
Fax
(516) 433-1895
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Farhad H Shirazi, MDNPI 1215000914
Title
Owner
Phone
(516) 433-4828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 196396 NY Primary

Addresses

Primary practice location

700 Old Country Rd
Suite 202
Plainview, NY 11803

Mailing address

700 Old Country Rd
Suite 202
Plainview, NY 11803
Phone (516) 433-4828

Other identifiers 1

IdentifierTypeStateIssuer
01837278MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110609000049 NY Part B Supplier - Clinic/Group Practice 5991831828 Receives reassigned benefits from 1 practitioner
Practice locations: Plainview, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0978163Moshe Shirazi MD700 Old Country Rd, Plainview, NY 11803Certificate of waiverSep 17, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1174707251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLD COUNTRY RD",
            "address_2": "SUITE 202",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-433-4828",
            "fax_number": "516-433-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLD COUNTRY RD",
            "address_2": "SUITE 202",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-433-4828",
            "fax_number": "516-433-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHE H SHIRAZI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "SHIRAZI",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-433-4828",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "196396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01837278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.