Organization Active NPI

Lina Shihabuddin MD LLC

  • Geriatric Psychiatry Physician
  • Newark, NJ
National Provider Identifier
1538264890
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
Legal business name
LINA SHIHABUDDIN MD LLC
Practice address
495 N 13TH St
Newark, NJ 07107-1317
Phone
(973) 268-2492
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lina Shihabuddin, MDNPI 1528014925
Title
Owner
Phone
(973) 268-2492

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
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X NJ Primary

Addresses

Primary practice location

495 N 13TH St
Newark, NJ 07107-1317

Mailing address

6 Ironwood Rd
Short Hills, NJ 07078-1020
Phone (973) 268-2492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061218000521 NJ Part B Supplier - Clinic/Group Practice 1355340480 Receives reassigned benefits from 1 practitioner
Practice locations: Belleville, NJ

National Provider Directory

National Provider Directory

Locations

156 Lyons Ave
Newark, NJ 07112
Phone (201) 436-3900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538264890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 IRONWOOD RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781020",
            "telephone_number": "973-268-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINA SHIHABUDDIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIHABUDDIN",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-268-2492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.