Individual provider Active NPI

Shariyar Shahana Hadi, D.O.

  • Family Medicine Physician
  • Levittown, NY
National Provider Identifier
1316058050
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223326 Issued in NY
Practice address
100 Jerusalem Ave
Levittown, NY 11756-3718
Phone
(516) 513-0836
Fax
(516) 342-1452
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 223326 NY Primary

Addresses

Primary practice location

100 Jerusalem Ave
Levittown, NY 11756-3718

Mailing address

100 Jerusalem Ave
Levittown, NY 11756-3718
Phone (631) 736-4064

Other identifiers 1

IdentifierTypeStateIssuer
02285005MedicaidNY

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
I20091210000571 NY Practitioner - Family Practice 8921148669 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rehan Malik, MD P.C. Past Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1316058050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JERUSALEM AVE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563718",
            "telephone_number": "631-736-4064",
            "fax_number": "516-342-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JERUSALEM AVE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563718",
            "telephone_number": "516-513-0836",
            "fax_number": "516-342-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADI",
        "first_name": "SHARIYAR",
        "middle_name": "SHAHANA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "223326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02285005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.