NPIMap

Organization Active NPI

Queens Nassau Psychiatric Services PLLC

  • Psychiatry Physician
  • New Hyde Park, NY
National Provider Identifier
1508267113
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
QUEENS NASSAU PSYCHIATRIC SERVICES PLLC
Practice address
26619 Union Tpke
New Hyde Park, NY 11040-1426
Phone
(917) 412-0243
NPI assigned
Sep 15, 2014
Last updated
Sep 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Dr. Sandip P Sheth, M.D.NPI 1972548915
Title
Owner
Phone
(516) 216-4108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

26619 Union Tpke
New Hyde Park, NY 11040-1426

Mailing address

15 Sunset Rd N
Albertson, NY 11507-1132
Phone (917) 412-0243

Other identifiers 1

IdentifierTypeStateIssuer
01618088MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150513001714 NY Part B Supplier - Clinic/Group Practice 8628398765 Receives reassigned benefits from 14 practitioners
Practice locations: Whitestone, NY; New Hyde Park, NY; Great Neck, NY; Flushing, NY; Bayside, NY; Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1508267113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SUNSET RD N",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071132",
            "telephone_number": "917-412-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26619 UNION TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401426",
            "telephone_number": "917-412-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS NASSAU PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "SHETH",
        "authorized_official_first_name": "SANDIP",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-216-4108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01618088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.