Individual provider Active NPI

Vahe Sis Shahnazarian, M.D.

  • Gastroenterology Physician
  • Staten Island, NY
National Provider Identifier
1265770085
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
284847 Issued in NY
Practice address
78 Todt Hill Rd Ste 203
Staten Island, NY 10314-4528
Phone
(718) 448-1122
Fax
(718) 448-8318
NPI assigned
Jan 29, 2013
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 138397 CA
Gastroenterology Physician 207RG0100X 284847 NY Primary
Internal Medicine Physician 207R00000X 284847 NY

Addresses

Primary practice location

78 Todt Hill Rd Ste 203
Staten Island, NY 10314-4528

Mailing address

2066 Richmond Ave Ste 2L
Staten Island, NY 10314-3961
Phone (718) 448-1122

Other practice location 1

1102 Bay Ridge Pkwy
Brooklyn, NY 11228-2338
Phone (718) 748-2110

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
I20200416001835 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 4486903960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1058 Forest Ave
Staten Island, NY 10310-2419
Phone (718) 818-1058

355 Bard Ave
Staten Island, NY 10310-1664

4360 Hylan Blvd
Staten Island, NY 10312-6533
Phone (718) 818-5000

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284847NYMDInternal Medicine Physician
138397CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Mar 4, 2021 Accepting new patients
Amboy Medical Practice PC Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 1, 2020 Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

300 Community Dr
Manhasset, NY 11030

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

800 Castleton Ave
Staten Island, NY 10310
Phone (718) 354-3344

2066 Richmond Ave
Ste 2L
Staten Island, NY 10314

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: vahe.shahnazarian.1@19656.direct.athenahealth.com
  • Direct secure messaging: vaheshahnazarian@mai.allscriptsdirect.net
  • Direct secure messaging: vshahnazarian65610@northwell.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1265770085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 RICHMOND AVE STE 2L",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143961",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD STE 203",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 Bay Ridge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112282338",
            "country_code": "US",
            "telephone_number": "718-748-2110",
            "fax_number": "718-748-1666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHNAZARIAN",
        "first_name": "VAHE",
        "middle_name": "SIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "138397",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "284847",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "284847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.