Advanced Internal Medicine, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

236142 Issued in NY

Legal business name

ADVANCED INTERNAL MEDICINE, P.C.

Practice address

935 Northern Blvd Ste 105
Great Neck, NY 11021-5309

Phone

(516) 487-0070

Fax

(516) 487-0072

NPI assigned

Aug 8, 2012

Last updated

Nov 28, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shahram Daniel Shamekh, M.D.NPI 1063468627

Title

President/Ceo

Phone

(516) 455-7017

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shahram Daniel Shamekh, MD

  • Internal Medicine Physician
  • Great Neck, NY
  • NPI 1063468627
  Medicare reassignment NPD Authorized official
• Shahram Hormozi, M.D.

  • Interventional Cardiology Physician
  • Hauppauge, NY
  • NPI 1215916721
  Medicare reassignment NPD

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1467709451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GRISTMILL LN",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231839",
            "telephone_number": "516-455-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 NORTHERN BLVD STE 105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215309",
            "telephone_number": "516-487-0070",
            "fax_number": "516-487-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "SHAMEKH",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "516-455-7017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Adessa
• Joan D Adickman, PH. D.
• Steven Joel Adlow, D.D.S.
• Barbara A Adomsky, DPT
• Advance Carevana Inc
• Advanced Medical Health Services PC
• Advanced Medical Imaging of Long Island PC
• Advanced Psychological Services LLC
• Advantus Home Care Inc.
• Aesthetic Plastic Surgery PC

• Internal Medicine Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.