Individual provider Active NPI

Arif Shahabuddin, MD

  • Student in an Organized Health Care Education/Training Program
  • Albany, NY
National Provider Identifier
1558522383
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
62537 Issued in NY
Practice address
47 New Scotland Ave
Department of Psychiatry
Albany, NY 12208-3412
Phone
(518) 626-5511
NPI assigned
Jun 24, 2008
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 62537 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Department of Psychiatry
Albany, NY 12208-3412

Mailing address

461 State St
First Floor
Albany, NY 12203-1022
Phone (617) 460-1475

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
I20161208000928 NY Practitioner - Psychiatry 8527359157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Equinox Inc.Group PAC ID 7416946538, 5 clinicians

Practice addresses (Care Compare)

500 Central Ave
Albany, NY 12206-2213
Phone (518) 435-9931

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62537NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Equinox Inc CurrentSince Oct 15, 2016 Accepting new patients

Locations

500 Central Ave
Albany, NY 12206
Phone (518) 435-9931

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1558522383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 STATE ST",
            "address_2": "FIRST FLOOR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122031022",
            "telephone_number": "617-460-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-626-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHABUDDIN",
        "first_name": "ARIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "62537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.