Active NPI
Yitzchak Isaac Shalam, PA-C
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1275319808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 034100
- Practice address
- 1538 Ocean Pkwy
Brooklyn, NY 11230-7004 - Phone
- (347) 525-4560
- NPI assigned
- Sep 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 034100 | NY | Primary |
Addresses
Primary practice location
1538 Ocean Pkwy
Brooklyn, NY 11230-7004
Mailing address
1538 Ocean Pkwy
Brooklyn, NY 11230-7004
Phone (347) 525-4560
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251230000128 | NY | Order and Referring Only - Physician Assistant | 8729574736 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034100 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763078400000",
"number": "1275319808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1538 OCEAN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112307004",
"telephone_number": "347-525-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1538 OCEAN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112307004",
"telephone_number": "347-525-4560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHALAM",
"first_name": "YITZCHAK",
"middle_name": "ISAAC",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-08",
"last_updated": "2025-11-14",
"certification_date": "2025-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "NY",
"license": "034100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.