Individual provider Active NPI

Jalees Ahmed, MD

  • Psychiatry Physician
  • Farmingdale, NY
National Provider Identifier
1215945811
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
221623 Issued in NY
Practice address
240 Lilac CT
Farmingdale, NY 11735-7007
Phone
(516) 302-6240
NPI assigned
Aug 3, 2006
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 221623 NY
Psychiatry Physician 2084P0800X 221623 NY Primary

Addresses

Primary practice location

240 Lilac CT
Farmingdale, NY 11735-7007

Mailing address

240 Lilac CT
Farmingdale, NY 11735-7007
Phone (516) 302-6240

Other identifiers 1

IdentifierTypeStateIssuer
02322118MedicaidNY

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
I20040401000103 NY Practitioner - PsychiatryPractitioner - Geriatric PsychiatryPractitioner - Addiction Medicine 6002808854 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-4010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince Oct 4, 2012 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Nov 7, 2018 Accepting new patients
South Shore Magnetic Resonance Imaging Associates PC CurrentSince Aug 13, 2016 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Good Samaritan Hospital Medical CurrentSince Jan 1, 2013 Accepting new patients
Jalees Ahmed Physician PC Psychiatry CurrentSince Jun 29, 2022 Accepting new patients
Brunswick Hospital Center, Inc Past Accepting new patients
Downstate Mental Hygiene Associates Past Accepting new patients
RS Neuro Medical, P.C. PastSince May 1, 2007 Accepting new patients

Locations

60 Louden Ave
Amityville, NY 11701
Phone (631) 841-2900

81 Louden Ave
Amityville, NY 11701
Phone (631) 789-5758

910 Route 109
Lindenhurst, NY 11757
Phone (631) 546-5081

910 Route 109
Ste B
Lindenhurst, NY 11757
Phone (516) 279-6210

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 9

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

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1215945811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 LILAC CT",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117357007",
            "telephone_number": "516-302-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 LILAC CT",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117357007",
            "telephone_number": "516-302-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "JALEES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "221623",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "221623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02322118",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.