Individual provider Active NPI

Alla Sabzanova, D.O.

  • Internal Medicine Physician
  • Astoria, NY
National Provider Identifier
1407960529
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
239119 Issued in NY
Practice address
4604 31St Ave
Suite B
Astoria, NY 11103-1842
Phone
(718) 545-2100
Fax
(718) 545-1900
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

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 239119 NY Primary

Addresses

Primary practice location

4604 31St Ave
Suite B
Astoria, NY 11103-1842

Mailing address

2202 Steinway St
Astoria, NY 11105-1875
Phone (718) 423-0808

Other identifiers 1

IdentifierTypeStateIssuer
02802353MedicaidNY

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
I20061109000699 NY Practitioner - Internal Medicine 6406854223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

150 -55
Whitestone, NY 11357-1817
Phone (718) 559-3300

15055 14TH Ave
Whitestone, NY 11357-1817
Phone (718) 559-3300

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239119NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Boro Medical, P.C. Internal Medicine Past Accepting new patients
Boro Medical, P.C. Internal Medicine Past Accepting new patients
Ark Medical Associates PC Internal Medicine Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

2202 Steinway St
Long Is City, NY 11105
Phone (718) 423-0808

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: allasabzanova@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1407960529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051875",
            "telephone_number": "718-423-0808",
            "fax_number": "718-204-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 31ST AVE",
            "address_2": "SUITE B",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031842",
            "telephone_number": "718-545-2100",
            "fax_number": "718-545-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABZANOVA",
        "first_name": "ALLA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02802353",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.