Idan Sharon, MD, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

197670 Issued in NY

Legal business name

IDAN SHARON, MD, PC

Practice address

345 Seaview Ave
Staten Island, NY 10305-2244

Phone

(718) 680-8105

Fax

(718) 680-6556

NPI assigned

Mar 20, 2008

Organization subpart

No

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

Authorized official

Name

Idan Sharon, MDNPI 1205852845

Title

Authorized Official

Phone

(718) 680-8105

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Idan Sharon, M.D.

  • Specialist
  • Brooklyn, NY
  • NPI 1205852845
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1689845315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 BOND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314812",
            "telephone_number": "718-680-8105",
            "fax_number": "718-680-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052244",
            "telephone_number": "718-680-8105",
            "fax_number": "718-680-6556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6917 Shore Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112091057",
            "country_code": "US",
            "telephone_number": "718-680-8105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IDAN SHARON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SHARON",
        "authorized_official_first_name": "IDAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "718-680-8105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "197670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02085821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Inna Ichtchenko, BS IN PHARMACY
• Ichthysroe, LLC
• Ics Care
• Liza Idelchik, DDS
• Awele Idemudia
• Jincy Idicula, RPH
• Daniel Jose Idoate Domench
• Roseann Idone, M.S., CCC-SLP

• Specialist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.