Forest Hills Psychiatric PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R056338 Issued in NY

Legal business name

FOREST HILLS PSYCHIATRIC PC

Practice address

76-03 113TH St
Forest Hills, NY 11375-6585

Phone

(718) 268-1100

Fax

(718) 268-6418

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Shama Rasool, MDNPI 1588678718

Title

Psychiatrist

Phone

(718) 268-1100

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shama Rasool, MD

  • Psychiatry Physician
  • Forest Hills, NY
  • NPI 1588678718
  Medicare reassignment NPD Authorized official
• Sohail Iqbal Cheema, M.D

  • Child & Adolescent Psychiatry Physician
  • Westbury, NY
  • NPI 1457483042
  NPD (past)
• Annupriya Itteera, MD

  • Psychiatry Physician
  • New Hyde Park, NY
  • NPI 1518922939
  NPD (past)
• Mini Pothen

  • Psychologist
  • Forest Hills, NY
  • NPI 1548369184
  NPD (past)
• Ayaz Rasool, MD

  • Urology Physician
  • Forest Hills, NY
  • NPI 1467561043
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1437218674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76-03 113TH STREET",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756585",
            "telephone_number": "718-268-1100",
            "fax_number": "718-263-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76-03 113TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756585",
            "telephone_number": "718-268-1100",
            "fax_number": "718-268-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILLS PSYCHIATRIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "RASOOL",
        "authorized_official_first_name": "SHAMA",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "718-268-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "016036",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R056338",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "159418",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MINI POTHEN LICENSE#",
            "identifier": "016036",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00929204",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. RASOOL LICENSE#",
            "identifier": "159418",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forest Hills Organics Inc
• Forest Hills Orthopedic Group P.C
• Forest Hills Pediatrics LLP
• Forest Hills Physical Medicine & Rehabilitation Services PC
• Forest Hills Physical Therapy, PC
• Forest Hills Psychiatric Services, P.C
• Forest Hills Specialized Services, Inc.
• Forest Hills Surgery Obs PC
• Forest Hills Surgical Associates PC
• Forest Hills Surgical Care PLLC

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.