Shaun Shazam Ali

Primary specialty

DriverTaxonomy code 172A00000X

License

B03211 Issued in NY

Practice address

10120 Liberty Ave
Ozone Park, NY 11417-1702

Phone

(718) 480-6875

Fax

(718) 480-1267

NPI assigned

Jul 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Greenlight Transportation Service LLC

  • Non-emergency Medical Transport (VAN)
  • Ozone Park, NY
  • NPI 1083260103
  NPD (past) Authorized official

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1386296473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 LIBERTY AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171702",
            "telephone_number": "718-480-6875",
            "fax_number": "718-480-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 LIBERTY AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171702",
            "telephone_number": "718-480-6875",
            "fax_number": "718-480-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "SHAUN",
        "middle_name": "SHAZAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NY",
            "license": "B03211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akhtar Ali, MD PC
• Al-Haqq Pharmacy Inc
• Sumaiya Alam, FNP
• Esssam Y Aldoais, RPH
• Alexia S Pharmacy Inc
• All Axis Medical PC
• All Medical Equipments Inc
• Allstate Medical Equipment, Inc.
• Luis A Almonte, MD
• Adriana Alvigi, RPH

• Driver in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• Driver in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.