Individual provider Active NPI

Omar Shaaban, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1306588017
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
338590-01 Issued in NY
Practice address
1345 Avenue of the Americas FL 8
New York, NY 10105-0018
Phone
(855) 624-8963
NPI assigned
Apr 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 338590-01 NY
Emergency Medicine Physician 207P00000X 338590-01 NY Primary

Addresses

Primary practice location

1345 Avenue of the Americas FL 8
New York, NY 10105-0018

Mailing address

8900 Van Wyck Expy
Jamaica, NY 11418-2897

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
I20251030000060 NY Practitioner - Family Practice 7517456502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Penn PLZ
New York, NY 10001-1810
Phone (646) 647-1249

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338590-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 29, 2025 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 29, 2025 Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

1345 Avenue of the Americas
Fl 8
New York, NY 10105
Phone (212) 913-0828

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: omar.shaaban.1@2983.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1306588017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050018",
            "telephone_number": "855-624-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAABAN",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "338590-01",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "338590-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.