Individual provider Active NPI

Sarah Mazher Kidwai, M.D.

  • Facial Plastic Surgery Physician
  • Seattle, WA
National Provider Identifier
1356736730
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
MD61030955 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-2305
Phone
(206) 520-5000
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X MD61030955 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-2305

Mailing address

1063 Maple LN
New Hyde Park, NY 11040-2305
Phone (516) 776-8173

Other identifiers 1

IdentifierTypeStateIssuer
1356736730MedicaidWA

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
I20220103000133 NY Practitioner - Plastic and Reconstructive Surgery 8426394768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Albany Medical College of Union University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (631) 675-4550

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

444 Lakeville Rd
New Hyde Park, NY 11042-1120
Phone (516) 386-4744

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Oct 5, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Oct 5, 2021 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

444 Lakeville Rd
New Hyde Park, NY 11042
Phone (516) 352-4400

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: skidwai67614@northwell.direct-ci.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1356736730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 MAPLE LN",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402305",
            "telephone_number": "516-776-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981952305",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWAI",
        "first_name": "SARAH",
        "middle_name": "MAZHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WA",
            "license": "MD61030955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356736730",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.