Individual provider Active NPI

Kanza Shamim, MD

  • Internal Medicine Physician
  • Plainview, NY
National Provider Identifier
1558004689
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
338032 Issued in NY
Practice address
888 Old Country Rd
Plainview, NY 11803-4914
Phone
(516) 719-3000
NPI assigned
Apr 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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 338032 NY Primary

Addresses

Primary practice location

888 Old Country Rd
Plainview, NY 11803-4914

Mailing address

1111 Marcus Ave Ste M04
New Hyde Park, NY 11042-1034
Phone (585) 736-3650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260114000231 NY Practitioner - Internal MedicinePractitioner - Hospitalist 5395221972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338032NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Feb 5, 2026 Accepting new patients

Locations

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

300 Community Dr
Plandome, NY 11030

221 Jericho Tpke
#1N
Syosset, NY 11791
Phone (516) 496-6582

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1558004689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MARCUS AVE STE M04",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421034",
            "telephone_number": "585-736-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034914",
            "telephone_number": "516-719-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIM",
        "first_name": "KANZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-17",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "338032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.