Individual provider Active NPI

Gulru Sharifova

  • Hospitalist Physician
  • Massapequa Park, NY
National Provider Identifier
1609296508
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
290158 Issued in NY
Practice address
162 McKinley St
Massapequa Park, NY 11762-2625
Phone
(516) 776-7820
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X 290158 NY Primary

Addresses

Primary practice location

162 McKinley St
Massapequa Park, NY 11762-2625

Mailing address

Southside Hospital
301 E Main St
Bay Shore, NY 11706-8408
Phone (516) 776-7820

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL gsharifo@northwell.edu Health Information Exchange (HIE)

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
I20171120002173 NY Practitioner - Internal Medicine 6204193634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
290158NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Single Specialty CurrentSince Sep 24, 2017 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 24, 2017 Accepting new patients
South Shore University Hospital Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

4230 Hempstead Tpke
Ste 200
Bethpage, NY 11714
Phone (516) 656-1414

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1010 Northern Blvd
Ste 328
Great Neck, NY 11021
Phone (516) 354-7900

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1609296508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHSIDE HOSPITAL",
            "address_2": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "516-776-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MCKINLEY ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622625",
            "telephone_number": "516-776-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFOVA",
        "first_name": "GULRU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "290158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gsharifo@northwell.edu",
            "affiliation": "N",
            "endpointDescription": "hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 E Main St",
            "city": "Bay Shore",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117068408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

Verify at the official NPI Registry.