Individual provider Active NPI

Shehryar Ahmed Malik, DO

  • Family Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1285154419
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
331761 Issued in NY
Practice address
100 Nicolls Rd # T16-030
Stony Brook, NY 11794-9612
Phone
(631) 444-8478
Fax
(631) 444-7546
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 331761 NY Primary
Family Medicine Physician 207Q00000X 2018030876 MO

Addresses

Primary practice location

100 Nicolls Rd # T16-030
Stony Brook, NY 11794-9612

Mailing address

100 Nicolls Rd # 16-030
Stony Brook, NY 11794-0001
Phone (631) 444-8478

Other practice location 1

1280 W US Highway 40
Odessa, MO 64076-9612
Phone (816) 633-5774

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219002357 NY Practitioner - Hospitalist 2264786847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
89.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 27, 2024 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 27, 2024 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

100 Nicolls Rd
#16030
Stony Brook, NY 11794

100 Nicolls Rd
#T16030
Stony Brook, NY 11794
Phone (631) 444-3655

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1285154419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD # 16-030",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-8478",
            "fax_number": "631-444-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD # T16-030",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117949612",
            "telephone_number": "631-444-8478",
            "fax_number": "631-444-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 W US Highway 40",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "MO",
            "postal_code": "640769612",
            "country_code": "US",
            "telephone_number": "816-633-5774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIK",
        "first_name": "SHEHRYAR",
        "middle_name": "AHMED",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "331761",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018030876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.