Individual provider Active NPI

Maryam Heshami, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1609543446
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
109231-2 Issued in NY
Practice address
2975 Independence Ave
Bronx, NY 10463-4620
Phone
(718) 548-1700
NPI assigned
Aug 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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 109231-2 NY Primary

Addresses

Primary practice location

2975 Independence Ave
Bronx, NY 10463-4620

Mailing address

2975 Independence Ave
Bronx, NY 10463-4620
Phone (845) 637-8017

Other practice location 1

48 Cedar St
Brooklyn, NY 11221-3253
Phone (718) 455-6200

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
I20210907002003 NY Practitioner - Internal Medicine 8325444995 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109231-2NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Neurological Associates, PC CurrentSince Feb 1, 2025 Accepting new patients
Ilm Medical Care PLLC CurrentSince Jan 6, 2024 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

4256 Bronx Blvd
Ste 5
Bronx, NY 10466
Phone (718) 655-9111

4234 Bronx Blvd
Frnt 1
Bronx, NY 10466
Phone (718) 655-9111

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

48 Cedar St
Brooklyn, NY 11221
Phone (718) 455-6200

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630195200000",
    "number": "1609543446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 INDEPENDENCE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634620",
            "telephone_number": "845-637-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 INDEPENDENCE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634620",
            "telephone_number": "718-548-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112213253",
            "country_code": "US",
            "telephone_number": "718-455-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HESHAMI",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-29",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "109231-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.