Organization Active NPI

Northwell Health

  • Gastroenterology Physician
  • Mineola, NY
National Provider Identifier
1538104377
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORTHWELL HEALTH
Practice address
300 Old Country Rd Ste 31
Mineola, NY 11501-4112
Phone
(516) 742-5252
Fax
(516) 742-7623
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Dr. Sushil K. Sharma, MD
Title
President
Phone
(516) 742-5252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

300 Old Country Rd Ste 31
Mineola, NY 11501-4112

Mailing address

300 Old Country Rd Ste 31
Mineola, NY 11501-4112
Phone (516) 742-5252

National Provider Directory

National Provider Directory

Locations

901 Stewart Ave
Ste 2
Garden City, NY 11530
Phone (516) 742-5252

901 Stewart Ave
Ste 235
Garden City, NY 11530
Phone (516) 742-5252

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1538104377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD STE 31",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014112",
            "telephone_number": "516-742-5252",
            "fax_number": "516-742-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD STE 31",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014112",
            "telephone_number": "516-742-5252",
            "fax_number": "516-742-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWELL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "SUSHIL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-742-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.