Organization Active NPI

Sapna Shah Family Medicine PC

  • Family Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1386162089
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249371 Issued in NY
Legal business name
SAPNA SHAH FAMILY MEDICINE PC
Practice address
1575 Hillside Ave Ste 203
New Hyde Park, NY 11040-2501
Phone
(718) 570-7856
Fax
(516) 517-9515
NPI assigned
Sep 1, 2017
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Sapna Shah, MDNPI 1659534543
Title
Owner
Phone
(718) 570-7856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 249371 NY Primary

Addresses

Primary practice location

1575 Hillside Ave Ste 203
New Hyde Park, NY 11040-2501

Mailing address

32 Cresthollow LN
Albertson, NY 11507-1047
Phone (718) 570-7856

Other identifiers 1

IdentifierTypeStateIssuer
03023874MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171219000722 NY Part B Supplier - Clinic/Group Practice 7315205499 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2187524Sapna Shah Family Medicine PC1575 Hillside Ave Ste 203, New Hyde Park, NY 11040Certificate of waiverJul 1, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1386162089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CRESTHOLLOW LN",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071047",
            "telephone_number": "718-570-7856",
            "fax_number": "516-517-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE STE 203",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "718-570-7856",
            "fax_number": "516-517-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAPNA SHAH FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SAPNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-570-7856",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "249371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03023874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.