Active NPI
Mamdouh Ahmed Shehata, PT,DPT
- Physical Therapist
- Staten Island, NY
National Provider Identifier
1184869364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 018313
- Practice address
- 19 Rosebank PL
Staten Island, NY 10305-1845 - Phone
- (917) 549-7537
- Fax
- (718) 448-5711
- NPI assigned
- Dec 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 018313 | NY | Primary |
Addresses
Primary practice location
19 Rosebank PL
Staten Island, NY 10305-1845
Mailing address
19 Rosebank PL
Staten Island, NY 10305-1845
Phone (917) 549-7537
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228176000000",
"number": "1184869364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 ROSEBANK PL",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103051845",
"telephone_number": "917-549-7537",
"fax_number": "718-448-5711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 ROSEBANK PL",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103051845",
"telephone_number": "917-549-7537",
"fax_number": "718-448-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEHATA",
"first_name": "MAMDOUH",
"middle_name": "AHMED",
"name_prefix": "Dr.",
"credential": "PT,DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-02",
"last_updated": "2008-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "018313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.