Individual provider Active NPI

Shehla Hasnain Naqvi, MD

  • Pediatrics Physician
  • Mount Vernon, NY
National Provider Identifier
1235191925
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
204220959 Issued in NY
Practice address
105 Stevens Ave
Suite 502
Mount Vernon, NY 10550-2686
Phone
(914) 667-4142
Fax
(914) 667-4121
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 204220959 NY Primary
Pediatrics Physician 208000000X 189788 NY

Addresses

Primary practice location

105 Stevens Ave
Suite 502
Mount Vernon, NY 10550-2686

Mailing address

105 Stevens Ave
Suite 502
Mount Vernon, NY 10550-2686
Phone (914) 667-4142

Other identifiers 1

IdentifierTypeStateIssuer
01430157MedicaidNY

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
I20161109000369 NY Practitioner - Pediatric Medicine 4385923671 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204220959NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Family Care Center, Inc. Pediatrics CurrentSince Sep 3, 2016 Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Sep 3, 2016 Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Oct 28, 2017 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Oct 28, 2017 Accepting new patients

Locations

1095 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 240-5132

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Networks

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

Interoperability endpoints

  • Direct secure messaging: shehla.naqvi.1@18107.direct.athenahealth.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1235191925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 STEVENS AVE",
            "address_2": "SUITE 502",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502686",
            "telephone_number": "914-667-4142",
            "fax_number": "914-667-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 STEVENS AVE",
            "address_2": "SUITE 502",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502686",
            "telephone_number": "914-667-4142",
            "fax_number": "914-667-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAQVI",
        "first_name": "SHEHLA",
        "middle_name": "HASNAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "204220959",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01430157",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.