Individual provider Active NPI

MD Shah Alam, MD

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1659516417
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
254156 Issued in NY
Practice address
17007 Hillside Ave
Jamaica, NY 11432-4546
Phone
(347) 380-9050
Fax
(347) 380-9057
NPI assigned
Dec 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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 254156 NY Primary

Addresses

Primary practice location

17007 Hillside Ave
Jamaica, NY 11432-4546

Mailing address

708 Salisbury Park Dr
Westbury, NY 11590-5820
Phone (516) 385-1668

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
I20111101000692 NY Practitioner - Internal Medicine 0749453009 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hossen Podiatry LLC CurrentSince Jul 26, 2023 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Montefiore Medical Center CurrentSince Nov 1, 2011 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2153 Westchester Ave
Bronx, NY 10462
Phone (347) 748-4732

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • 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.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1659516417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 SALISBURY PARK DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905820",
            "telephone_number": "516-385-1668",
            "fax_number": "347-380-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17007 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324546",
            "telephone_number": "347-380-9050",
            "fax_number": "347-380-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "MD",
        "middle_name": "SHAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-09",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.