Active NPI
Carly Rose Sheahan, DO
- Emergency Medicine Physician
- Westbury, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 331632
- Practice address
- 965 Gloucester CT
Westbury, NY 11590-5301 - Phone
- (516) 205-8337
- NPI assigned
- Apr 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 331632 | NY | Primary |
Addresses
Primary practice location
965 Gloucester CT
Westbury, NY 11590-5301
Mailing address
965 Gloucester CT
Westbury, NY 11590-5301
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 986-3308
Hospital & facility affiliations
- NS/Lij HS Southside Hospital
- North Shore University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331632 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exigence Medical of Binghamton PLLC | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Emergency Medicine | Current | Accepting new patients |
| John T. Mather Memorial Hospital | Current | Accepting new patients |
Locations
301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977
169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
300 Community Dr
Plandome, NY 11030
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- csheahan204176@direct-guthrie.org
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Binghamton, NY
- NPI 1659464758
-
- Critical Care Medicine (Internal Medicine) Physician
- Port Jefferson, NY
- NPI 1467249334
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
-
- General Acute Care Hospital
- Bay Shore, NY
- NPI 1457369381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1326628504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 GLOUCESTER CT",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115905301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 GLOUCESTER CT",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115905301",
"telephone_number": "516-205-8337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEAHAN",
"first_name": "CARLY",
"middle_name": "ROSE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "331632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.