Individual provider Active NPI

Sikander Manzoor, MD

  • Pediatrics Physician
  • Richmond Hill, NY
National Provider Identifier
1235199266
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
210689 Issued in NY
Practice address
12102 Hillside Ave
Richmond Hill, NY 11418-1812
Phone
(718) 850-1673
Fax
(718) 849-5133
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 210689 NY Primary

Addresses

Primary practice location

12102 Hillside Ave
Richmond Hill, NY 11418-1812

Mailing address

12102 Hillside Ave
Richmond Hill, NY 11418-1812
Phone (718) 850-1673

Other practice location 1

2215 Burdett Ave Fl 2
Troy, NY 12180-2466
Phone (518) 272-7614

Other practice location 2

1300 Massachusetts Ave
Troy, NY 12180-1628
Phone (518) 272-7614

Other identifiers 1

IdentifierTypeStateIssuer
01867578MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20090314000037 NY Practitioner - Pediatric Medicine 9537226741 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Apr 1, 2024 Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients
St. Peter'S Hospital of the City of Albany Pediatrics CurrentSince Apr 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of New York, PLLC Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

53 Columbia St
Rensselaer, NY 12144
Phone (518) 434-2526

2215 Burdett Ave
Fl 2
Troy, NY 12180
Phone (518) 270-3008

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

500 Federal St
Ste 602
Troy, NY 12180
Phone (518) 272-7614

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

Interoperability endpoints

  • Direct secure messaging: smanzoor85100@direct.trinity-health.org

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1235199266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12102 HILLSIDE AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181812",
            "telephone_number": "718-850-1673",
            "fax_number": "718-849-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12102 HILLSIDE AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181812",
            "telephone_number": "718-850-1673",
            "fax_number": "718-849-5133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-272-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-272-7614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZOOR",
        "first_name": "SIKANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "210689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867578",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1300 Massachusetts Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.