Individual provider Active NPI

Abdul Shahin, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1316314636
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018955 Issued in NY
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1822
Phone
(718) 604-5000
NPI assigned
Aug 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018955 NY Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1822

Mailing address

3720 90TH St
Apt 2a
Jackson Heights, NY 11372-7881
Phone (347) 741-5748

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160129000054 NY Practitioner - Physician Assistant 1951604669 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018955NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsbrook Medical Associates PC CurrentSince Dec 1, 2015 Accepting new patients

Locations

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEGIAA/Endpoint/BEGIAA

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1316314636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 90TH ST",
            "address_2": "APT 2A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727881",
            "telephone_number": "347-741-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-604-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIN",
        "first_name": "ABDUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.