Individual provider Active NPI

Saniya Noor Kibria, MD

  • Child & Adolescent Psychiatry Physician
  • Bay Shore, NY
National Provider Identifier
1467719161
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
272907 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(917) 244-6963
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 272907 NY Primary
Psychiatry Physician 2084P0800X 272907 NY

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

12 Beach Hill Dr
Northport, NY 11768-1424
Phone (917) 244-6963

Other practice location 1

110 E 88th St
New York, NY 10128-1103
Phone (212) 987-2717

Other practice location 2

233 7th St Ste 200
Garden City, NY 11530-5747
Phone (516) 515-1190

Other practice location 3

7559 263rd St
Glen Oaks, NY 11004-1150
Phone (718) 470-8140

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
I20180113000041 NY Practitioner - Psychiatry 8628337961 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272907NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 4, 2017 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

233 7th St
Ste 200
Garden City, NY 11530
Phone (516) 524-8570

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467719161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BEACH HILL DR",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681424",
            "telephone_number": "917-244-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "917-244-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E 88th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101281103",
            "country_code": "US",
            "telephone_number": "212-987-2717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 7th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115305747",
            "country_code": "US",
            "telephone_number": "516-515-1190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7559 263rd St",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "110041150",
            "country_code": "US",
            "telephone_number": "718-470-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIBRIA",
        "first_name": "SANIYA",
        "middle_name": "NOOR",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "272907",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "272907",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.