Organization Active NPI

As Primary Care PC

  • Internal Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1649072786
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AS PRIMARY CARE PC
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(917) 331-7574
NPI assigned
Mar 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Arash ShiftehNPI 1154622421
Title
DO
Phone
(917) 331-7574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

82 Old Pond Rd
Great Neck, NY 11023-1032
Phone (917) 331-7574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250530000395 NY Part B Supplier - Clinic/Group Practice 2961911243 Receives reassigned benefits from 1 practitioner
Practice locations: Queens Village, NY; Hollis, NY; Jamaica, NY; New Hyde Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1649072786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 OLD POND RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231032",
            "telephone_number": "917-331-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "917-331-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AS PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "SHIFTEH",
        "authorized_official_first_name": "ARASH",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "917-331-7574"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.