NPIMap

Individual provider Active NPI

Shabana Jamil, MD

  • Internal Medicine Physician
  • Vestal, NY
National Provider Identifier
1518031848
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
229343 Issued in NY
Practice address
1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone
(607) 754-5342
Fax
(607) 754-5508
NPI assigned
Nov 20, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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 229343 NY Primary

Addresses

Primary practice location

1020 Vestal Pkwy E
Vestal, NY 13850-1748

Mailing address

1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone (607) 754-5342

Other identifiers 1

IdentifierTypeStateIssuer
02833856MedicaidNY

Other names 1

  • Shabana Naazir Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shabana.jamil@direct.lourdes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070613000209 NY Practitioner - Internal Medicine 3678513009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 5TH Ave
Owego, NY 13827-1620
Phone (607) 687-1122

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Internal Medicine CurrentSince Dec 27, 2006 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Dec 27, 2006 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

3101 Shippers Rd
Vestal, NY 13850
Phone (607) 250-2180

Interoperability endpoints

  • Direct secure messaging: sjamil196849@direct-guthrie.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1518031848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-754-5342",
            "fax_number": "607-754-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-754-5342",
            "fax_number": "607-754-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIL",
        "first_name": "SHABANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "229343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02833856",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shabana.jamil@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3101 Shippers Rd",
            "city": "Vestal",
            "state": "NY",
            "country_code": "US",
            "postal_code": "138502080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHABANA",
            "last_name": "NAAZIR",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.