Glen Oak Medical Care PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

230853-1 Issued in NY

Legal business name

GLEN OAK MEDICAL CARE PLLC

Practice address

262-05 Hillside Ave
Glen Oaks, NY 11004

Phone

(718) 343-6100

Fax

(516) 833-7470

NPI assigned

Nov 24, 2015

Last updated

May 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Saira K Shahab, MDNPI 1144271784

Title

Owner

Phone

(516) 270-4742

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Glen Oak Medical Care PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glen Oak Medical Care PLLC

  • Infectious Disease Physician
  • Floral Park, NY
  • NPI 1871901298
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Saira Khalid Shahab, MD

  • Infectious Disease Physician
  • Hempstead, NY
  • NPI 1144271784
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1316311608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26205 HILLSIDE AVE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041756",
            "telephone_number": "718-343-6100",
            "fax_number": "516-833-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262-05 HILLSIDE AVE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "11004",
            "telephone_number": "718-343-6100",
            "fax_number": "516-833-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN OAK MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "SHAHAB",
        "authorized_official_first_name": "SAIRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-270-4742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "230853-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2743593",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Najwa Ghani
• Jada Gibbs
• Alison Gilbert, PHD
• Emma Gill, MD
• Cecilia Elena Gimenez, MD
• Glen Oaks Family Vision Corp
• Glen Oaks Internal Medicine PC
• Glen Oaks Medical Associate PC
• Rosalyn Glicklich
• Jennie Goldstein, MD

• Internal Medicine Physician in Glen Oaks, NY
• Providers in Glen Oaks, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.