Individual provider Active NPI

Philippa Jayne Cheetham, MBCHB (HONS) MD MRCS

  • Urology Physician
  • Kew Gardens, NY
National Provider Identifier
1174772735
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
267290 Issued in NY
Practice address
8002 Kew Gardens Rd
Suite 323
Kew Gardens, NY 11415-3600
Phone
(646) 216-7979
Fax
(646) 216-7978
NPI assigned
Sep 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 267290 NY Primary

Addresses

Primary practice location

8002 Kew Gardens Rd
Suite 323
Kew Gardens, NY 11415-3600

Mailing address

200 Old Country Rd
Suite 520
Mineola, NY 11501-4235
Phone (646) 216-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130131000470 NY Practitioner - Urology 5496909350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 6709174493, 17 clinicians

Practice addresses (Care Compare)

200 Old Country Rd
Suite 520
Mineola, NY 11501-4298
Phone (516) 877-0977

Merit-based Incentive Payment System (MIPS)

Final score
84.62 of 100Reported as group
Quality
69.92
Promoting interoperability
100
Improvement activities
40
Cost
78.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Sep 1, 2016 Accepting new patients
Steven S Shayani MD PC CurrentSince Feb 1, 2015 Accepting new patients

Locations

393 Old Country Rd
Carle Place, NY 11514
Phone (516) 877-0977

5925 Kissena Blvd
Flushing, NY 11355
Phone (718) 280-9788

8002 Kew Gardens Rd
Ste 323
Kew Gardens, NY 11415
Phone (718) 268-6300

200 Old Country Rd
Ste 260
Mineola, NY 11501
Phone (516) 742-8787

200 Old Country Rd
Ste 520
Mineola, NY 11501
Phone (516) 877-0977

200 Old Country Rd
Ste 278
Mineola, NY 11501
Phone (516) 877-0977

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1174772735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 520",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "646-216-7979",
            "fax_number": "516-216-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD",
            "address_2": "SUITE 323",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153600",
            "telephone_number": "646-216-7979",
            "fax_number": "646-216-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEETHAM",
        "first_name": "PHILIPPA",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "MBCHB (HONS) MD MRCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "267290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.