Individual provider Active NPI

Shakib Nawaz Choudhury, DPM

  • Foot Surgery Podiatrist
  • Bronx, NY
National Provider Identifier
1396324711
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
007413 Issued in NY
Practice address
1434 Williamsbridge Rd
Bronx, NY 10461-2507
Phone
(718) 689-6847
NPI assigned
Apr 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 007413 NY
Student in an Organized Health Care Education/Training Program 390200000X
Foot Surgery Podiatrist 213ES0131X 007413 NY Primary

Addresses

Primary practice location

1434 Williamsbridge Rd
Bronx, NY 10461-2507

Mailing address

1434 Williamsbridge Rd
Bronx, NY 10461-2507
Phone (718) 689-6847

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904002615 NY Practitioner - Podiatry 0840730982 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

1371 Seabury Ave
Bronx, NY 10461-3651
Phone (718) 618-0401

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue631
Removal or shaving of skin growth57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007413NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Aug 3, 2024 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Jul 16, 2024 Accepting new patients
House Call Medical Services of New York, PLLC Podiatrist CurrentSince Jul 16, 2024 Accepting new patients
Essen Medical Associates, PC Podiatrist CurrentSince Aug 3, 2024 Accepting new patients

Locations

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1434 Williamsbridge Rd
Bronx, NY 10461
Phone (646) 759-5453

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Networks

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1396324711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-689-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-689-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "SHAKIB",
        "middle_name": "NAWAZ",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-04",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "007413",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "007413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.