Individual provider Active NPI

Idan Sharon, M.D.

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1205852845
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
197670 Issued in NY
Practice address
6917 Shore Rd
Brooklyn, NY 11209-1000
Phone
(718) 680-8105
Fax
(718) 680-6556
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 197670 NY Primary

Addresses

Primary practice location

6917 Shore Rd
Brooklyn, NY 11209-1000

Mailing address

398 Bond St
Brooklyn, NY 11231-4812
Phone (718) 680-8105

Other identifiers 1

IdentifierTypeStateIssuer
02085821MedicaidNY

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
I20050124000903 NY Practitioner - NeurologyPractitioner - Psychiatry 3375593866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6917 Shore Rd
Brooklyn, NY 11209-1057
Phone (718) 680-8105

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
16.1 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
53.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Idan Sharon, MD, PC Specialist CurrentSince Mar 1, 2003 Accepting new patients
LMC Physician Services, PC Past Accepting new patients

Locations

6917 Shore Rd
Brooklyn, NY 11209
Phone (718) 680-8105

345 Seaview Ave
Ste 2
Staten Island, NY 10305

345 Seaview Ave
Staten Island, NY 10305
Phone (718) 668-2340

Interoperability endpoints

  • Direct secure messaging: ids9008@direct.nyp.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1205852845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 BOND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314812",
            "telephone_number": "718-680-8105",
            "fax_number": "718-680-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 SHORE RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091000",
            "telephone_number": "718-680-8105",
            "fax_number": "718-680-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARON",
        "first_name": "IDAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "197670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02085821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.