Individual provider Active NPI

Ajitpal Singh Dhaliwal, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1669768016
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
278953 Issued in NY
Practice address
365 W 52ND St
Apt 4H
New York, NY 10019
Phone
(917) 306-5721
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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 278953 NY Primary

Addresses

Primary practice location

365 W 52ND St
Apt 4H
New York, NY 10019

Mailing address

800 Axinn Ave
Garden City, NY 11530-2139
Phone (646) 680-2888

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
I20160104002009 NY Practitioner - Internal Medicine 6800198128 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Internal Medicine Current Accepting new patients
Upstate Community Medical, PC CurrentSince Nov 6, 2018 Accepting new patients
Lagrangeville Medical PC Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Regenhealth Physicians LLC Internal Medicine Current Accepting new patients
St Josephs Medical PC Internal Medicine CurrentSince May 1, 2019 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Nov 1, 2022 Accepting new patients

Locations

2330 Eastchester Rd
Bronx, NY 10469
Phone (718) 228-0063

99 Emerson Pl
Ste 201
Brooklyn, NY 11205

71 Franklin Ave
Franklin Square, NY 11010
Phone (347) 885-9963

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

12 E 86th St
Ofc 3
New York, NY 10028
Phone (212) 517-9555

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Organizations & group practices 6

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1669768016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AXINN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302139",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 W 52ND ST",
            "address_2": "APT 4H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "917-306-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "AJITPAL",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "278953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.