Active NPI
Sherry Shariatmadar
- Anatomic Pathology & Clinical Pathology Physician
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 25MA12024000
- Practice address
- 1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005 - Phone
- (305) 585-6303
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 25MA12024000 | NJ | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | ME73969 | FL |
Addresses
Primary practice location
1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005
Mailing address
1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005
Phone (305) 585-6303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2527952-00 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12024000 | NJ | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore - Lij Medical PC | Current | Accepting new patients | |
| University Physician Associates of New Jersey Inc | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Nassau Health Care Corporation | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Nassau Health Care Corporation | Current | Accepting new patients | |
| University Physician Associates of New Jersey Inc | Current | Accepting new patients | |
| Nassau Health Care Corporation | Current | Accepting new patients |
Locations
150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056
30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037
2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234
2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Organizations & group practices 9
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.
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- Emergency Medicine Physician
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-
- General Acute Care Hospital
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- NPI 1720003312
-
- General Acute Care Hospital
- East Meadow, NY
- NPI 1730530940
-
- General Acute Care Hospital
- East Meadow, NY
- NPI 1902822992
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Internal Medicine Physician
- Newark, NJ
- NPI 1760492367
-
- Blood Banking & Transfusion Medicine Physician
- Newark, NJ
- NPI 1871503474
Anatomic Pathology & Clinical Pathology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775520000000",
"number": "1609880665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "BOX 016960 M851",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-6303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "BOX 016960 M851",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-6303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARIATMADAR",
"first_name": "SHERRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NJ",
"license": "25MA12024000",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "FL",
"license": "ME73969",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2527952-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.