Individual provider Active NPI

Waseem Shahid, M.D.

  • Family Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1619268745
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53804 Issued in CT
Practice address
161 Boston Ave
Bridgeport, CT 06610-1662
Phone
(203) 333-4400
Fax
(203) 334-0729
NPI assigned
Apr 24, 2011
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53804 CT Primary

Addresses

Primary practice location

161 Boston Ave
Bridgeport, CT 06610-1662

Mailing address

345 Central Park Ave
Apt D
Scarsdale, NY 10583-1361
Phone (347) 223-6987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151120001183 CT Practitioner - Family Practice 1052611126 Reassigns benefits to 3 organizations
I20180322001515 NY Practitioner - Family Practice 1052611126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Urgent Care Medical of New York LLCGroup PAC ID 5890071443, 40 clinicians

Practice addresses (Care Compare)

31 Old Route 7
Brookfield, CT 06804-1711
Phone (860) 650-3848

80 Route 6
Suite 704 705
Baldwin Place, NY 10505-1026
Phone (860) 650-3848

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical of New York, LLC CurrentSince Mar 12, 2018 Accepting new patients
QMG2,LLC CurrentSince Oct 15, 2015 Accepting new patients
Quentin Medical Group, LLC CurrentSince Sep 13, 2015 Accepting new patients
Urgent Care Medical Associates, LLC Family Medicine CurrentSince Mar 12, 2018 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

161 Boston Ave
Bridgeport, CT 06610
Phone (203) 333-4400

31 Old Route 7
Brookfield, CT 06804
Phone (203) 262-1911

1918 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 583-8400

2928 Main St
Ste 101
Glastonbury, CT 06033
Phone (860) 430-1246

10 South St
Ste 101
Ridgefield, CT 06877
Phone (203) 431-4600

389 Bridgeport Ave
Shelton, CT 06484
Phone (203) 567-4171

900 Main St S
Ste 100
Southbury, CT 06488
Phone (203) 262-1911

80 Route 6
Ste 704705
Baldwin Place, NY 10505
Phone (475) 253-2599

Organizations & group practices 5

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": "1303603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1619268745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CENTRAL PARK AVE",
            "address_2": "APT D",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831361",
            "telephone_number": "347-223-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 BOSTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101662",
            "telephone_number": "203-333-4400",
            "fax_number": "203-334-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHID",
        "first_name": "WASEEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-24",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "53804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.