Intercity Gastroenterology P.C

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

INTERCITY GASTROENTEROLOGY P.C

Practice address

19303 Union Tpke
Fresh Meadows, NY 11366-1874

Phone

(516) 721-4648

NPI assigned

Jun 9, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ghulamullah ShahzadNPI 1710128996

Title

President

Phone

(516) 784-8331

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ghulamullah Shahzad, MD

  • Gastroenterology Physician
  • Fresh Meadows, NY
  • NPI 1710128996
  Medicare reassignment Care Compare group NPD Authorized official
• Arif Hameed, MD

  • Anatomic Pathology Physician
  • East Norwich, NY
  • NPI 1952390866
  Medicare reassignment Care Compare group NPD
• Fangming Deng, M.D.

  • Anatomic Pathology Physician
  • Syracuse, NY
  • NPI 1205072352
  Medicare reassignment NPD
• Michael Khaham, D.O., RPH

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1790985596
  Medicare reassignment NPD
• Memona Ali

  • Physician Assistant
  • Jamaica, NY
  • NPI 1508552407
  Medicare reassignment
• Rupinder Kaur Nahal, PA

  • Physician Assistant
  • New Hyde Park, NY
  • NPI 1437608577
  Medicare reassignment

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1346779501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 N 1ST ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402821",
            "telephone_number": "516-784-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19303 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661874",
            "telephone_number": "516-721-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCITY GASTROENTEROLOGY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SHAHZAD",
        "authorized_official_first_name": "GHULAMULLAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-784-8331",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "252160",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03190443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Timothy Ip, O.D
• Alexandra Iskhakov, FNP
• Daniela Iskhakov, PA-C
• Olga Ismailov, MS CCC-SLP
• Elizabeth Ismailova, M.A., CCC-SLP

• Gastroenterology Physician in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.