Individual provider Active NPI

Imran Shaikh, M.D.

  • Psychiatry Physician
  • Ozone Park, NY
National Provider Identifier
1235326513
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
264908 Issued in NY
Practice address
9742 102ND St
Ozone Park, NY 11416-2618
Phone
(917) 403-6271
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X 264908 NY
Psychosomatic Medicine Physician 2084P0015X 0101237455 VA
Psychiatry Physician 2084P0800X 0101237455 VA
Psychiatry Physician 2084P0800X 264908 NY Primary

Addresses

Primary practice location

9742 102ND St
Ozone Park, NY 11416-2618

Mailing address

9742 102ND St
Ozone Park, NY 11416-2618
Phone (917) 403-6271

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
I20121231000036 NY Practitioner - Psychiatry 1153574074 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264908NYMDPsychiatry Physician
0101237455VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Neighborhood Services, Inc. CurrentSince Aug 20, 2014 Accepting new patients
Family Services, Inc. Psychiatry PastSince Apr 1, 2019 Accepting new patients
Medical Healthcare Services P.C. Psychiatry PastSince Jun 1, 2011 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Locations

191 Joralemon St
Fl 11
Brooklyn, NY 11201

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

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": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1235326513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9742 102ND ST",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162618",
            "telephone_number": "917-403-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9742 102ND ST",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162618",
            "telephone_number": "917-403-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIKH",
        "first_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NY",
            "license": "264908",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "VA",
            "license": "0101237455",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101237455",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "264908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.