NPIMap

Individual provider Active NPI

Hameed Azeb Shahul, M.B.B.S

  • Psychosomatic Medicine Physician
  • New York, NY
National Provider Identifier
1528514494
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
311028 Issued in NY
Practice address
1425 Madison Ave
New York, NY 10029-6514
Phone
(212) 659-8752
NPI assigned
Aug 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 311028 NY
Student in an Organized Health Care Education/Training Program 390200000X
Psychosomatic Medicine Physician 2084P0015X 311028 NY Primary

Addresses

Primary practice location

1425 Madison Ave
New York, NY 10029-6514

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 785-2618

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
I20210712001916 NY Practitioner - Psychiatry 1153723291 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

1425 Madison Ave
New York, NY 10029-6514
Phone (212) 824-8150

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 18, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1528514494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-785-2618",
            "fax_number": "203-737-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296514",
            "telephone_number": "212-659-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEB SHAHUL",
        "first_name": "HAMEED",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "311028",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NY",
            "license": "311028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.