Individual provider Active NPI

Ali Ahmadizadeh, MD

  • Otolaryngology Physician
  • Plainview, NY
National Provider Identifier
1376598805
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
254098 Issued in NY
Practice address
875 Old Country Rd
Plainview, NY 11803-4942
Phone
(516) 931-5552
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 254098 NY
Otolaryngology Physician 207Y00000X 254098 NY Primary

Addresses

Primary practice location

875 Old Country Rd
Plainview, NY 11803-4942

Mailing address

875 Old Country Rd
Plainview, NY 11803-4942
Phone (516) 931-5552

Other practice location 1

2475 Saint Raymonds Ave
Bronx, NY 10461-3124
Phone (718) 430-7300

Other identifiers 1

IdentifierTypeStateIssuer
03239012MedicaidNY

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
I20101203000913 NY Practitioner - OtolaryngologyPractitioner - Family Practice 0941294904 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1987
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)

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

875 Old Country Rd
FL 2
Plainview, NY 11803-4942
Phone (516) 470-8916

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
254098NYMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Medalliance Medical Health Services Inc CurrentSince Sep 1, 2017 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of New York, PLLC CurrentSince Sep 1, 2019 Accepting new patients
Lenox Hill Hospital Medical, PC Family Medicine CurrentSince Aug 24, 2013 Accepting new patients
Personal Health Imaging, PLLC Past Accepting new patients

Locations

2475 Saint Raymonds Ave
Bronx, NY 10461
Phone (718) 430-7300

625 E Fordham Rd
Bronx, NY 10458
Phone (718) 409-3433

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

300 Community Dr
Manhasset, NY 11030

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

875 Old Country Rd
Fl 2
Plainview, NY 11803
Phone (516) 470-8916

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: aahmadizadeh67602@northwell.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1376598805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-931-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-931-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2475 Saint Raymonds Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104613124",
            "country_code": "US",
            "telephone_number": "718-430-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMADIZADEH",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "254098",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "254098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03239012",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.