Individual provider Active NPI

Diyora Shehu, PA

  • Medical Physician Assistant
  • Englewood, NJ
National Provider Identifier
1407458466
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP01034200 Issued in NJ
Practice address
18 W. Palisades Ave.
Englewood, NJ 07631
Phone
(888) 663-6331
NPI assigned
Nov 13, 2020
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 25MP01034200 NJ Primary
Physician Assistant 363A00000X 026456 NY

Addresses

Primary practice location

18 W. Palisades Ave.
Englewood, NJ 07631

Mailing address

331 Newman Springs Rd.
BLDG 2, Ste 220
Red Bank, NJ 07701-5688

Other practice location 1

2633 Broadway
New York, NY 10025-5022
Phone (212) 321-7001

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622003317 NY Practitioner - Physician Assistant 8628479193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Medical of Ny PCGroup PAC ID 3274713110, 72 clinicians

Practice addresses (Care Compare)

2633 Broadway
New York, NY 10025-5022
Phone (888) 663-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
026456NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diyora Mirsaidova PA, P.C. Medical Current Accepting new patients
Montefiore Medical Center CurrentSince Nov 17, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Nov 17, 2025 Accepting new patients
One Medical of Ny, P.C. CurrentSince Jan 13, 2026 Accepting new patients
Montefiore Medical Center Current Accepting new patients

Locations

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

111 E 210th St
Bronx, NY 10467

2633 Broadway
New York, NY 10025
Phone (212) 321-7001

252 W 81st St
Fl 2
New York, NY 10024
Phone (212) 321-7001

919 3rd Ave
Ste 105
New York, NY 10022
Phone (212) 530-0650

589 3rd Ave
New York, NY 10016
Phone (212) 321-7002

Networks

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

Organizations & group practices 5

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1407458466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD.",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W. PALISADES AVE.",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2633 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100255022",
            "country_code": "US",
            "telephone_number": "212-321-7001",
            "fax_number": "415-252-7176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEHU",
        "first_name": "DIYORA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP01034200",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.