Individual provider Active NPI

Sherif Zaki-Wahba, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1568518009
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
231584 Issued in NY
Practice address
210 Flatbush Ave
Brooklyn, NY 11217-2116
Phone
(718) 783-0070
Fax
(718) 284-7197
NPI assigned
Jan 26, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 231584 NY Primary

Addresses

Primary practice location

210 Flatbush Ave
Brooklyn, NY 11217-2116

Mailing address

210 Flatbush Ave
Brooklyn, NY 11217-2116
Phone (718) 783-0070

Other identifiers 1

IdentifierTypeStateIssuer
01733471MedicaidNY

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
I20040522000144 NY Practitioner - Pediatric Medicine 4183615669 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231584NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Jan 30, 2019 Accepting new patients
Kings Physician Services, PC CurrentSince Jan 30, 2019 Accepting new patients

Locations

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

Interoperability endpoints

  • Direct secure messaging: ssz9004@direct.nyp.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568518009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172116",
            "telephone_number": "718-783-0070",
            "fax_number": "718-284-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172116",
            "telephone_number": "718-783-0070",
            "fax_number": "718-284-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKI-WAHBA",
        "first_name": "SHERIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "231584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01733471",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.