Individual provider Active NPI

Syed Shah, DO

  • Internal Medicine Physician
  • Garden City, NY
National Provider Identifier
1407365554
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
307051 Issued in NY
Practice address
975 Stewart Ave
Garden City, NY 11530-4816
Phone
(516) 222-8600
NPI assigned
Sep 20, 2017
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 307051 NY Primary

Addresses

Primary practice location

975 Stewart Ave
Garden City, NY 11530-4816

Mailing address

Advantagecare Physicians, PC
55 Water Street 2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

29 E 29th St
Bayonne, NJ 07002-4654
Phone (201) 858-5000

Other practice location 2

31-75 23rd Street
Astoria, NY 11106-4134
Phone (718) 956-2200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshah482258@nyumc.direct-ci.com

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
I20201215001951 NY Practitioner - Internal Medicine 3971781295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

975 Stewart Ave
Garden City, NY 11530-4816
Phone (516) 222-8602

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
New York University Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Laurelton Chemist Inc PastSince Jun 6, 2011 Accepting new patients
Nyumc Radiology Associates Past Accepting new patients

Locations

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • 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.

Hospital & facility affiliations 4

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1407365554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ADVANTAGECARE PHYSICIANS, PC",
            "address_2": "55 WATER STREET 2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304816",
            "telephone_number": "516-222-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 E 29th St",
            "address_purpose": "LOCATION",
            "city": "Bayonne",
            "state": "NJ",
            "postal_code": "070024654",
            "country_code": "US",
            "telephone_number": "201-858-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31-75 23rd Street",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111064134",
            "country_code": "US",
            "telephone_number": "718-956-2200",
            "fax_number": "718-956-2316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SYED",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "307051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah482258@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "975 Stewart Ave",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115304816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.