Active NPI
Kedambady Sheka
- Surgery Physician
- Brooklyn, NY
National Provider Identifier
1184634388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 123274-1
- Practice address
- 2601 Ocean Pkwy
Brooklyn, NY 11235-7745 - Phone
- (718) 616-4408
- Fax
- (718) 616-4105
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 123274-1 | NY | Primary |
Addresses
Primary practice location
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Mailing address
366 Ramona Ave
Staten Island, NY 10312-2611
Phone (718) 967-3506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00373973 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110839 | NY | MD | Social Worker |
| 123274-1 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Group Medical Associates, P.C | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1285683102
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184634388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "366 RAMONA AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103122611",
"telephone_number": "718-967-3506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 OCEAN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112357745",
"telephone_number": "718-616-4408",
"fax_number": "718-616-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEKA",
"first_name": "KEDAMBADY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "123274-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00373973",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.