Individual provider Active NPI

Sheldon Paul Hersh, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Forest Hills, NY
National Provider Identifier
1699885483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
138505 Issued in NY
Practice address
11011 72ND Ave
Suite 1B
Forest Hills, NY 11375-4946
Phone
(718) 261-9000
Fax
(718) 268-0504
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 138505 NY Primary

Addresses

Primary practice location

11011 72ND Ave
Suite 1B
Forest Hills, NY 11375-4946

Mailing address

11011 72ND Ave
Suite 1B
Forest Hills, NY 11375-4946
Phone (718) 261-9000

Other identifiers 1

IdentifierTypeStateIssuer
00744234MedicaidNY

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
I20110309000062 NY Practitioner - Otolaryngology 0749462992 Practice locations: Woodmere, NY; Forest Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York Medical College, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

949 Central Ave
Suite 201
Woodmere, NY 11598-1204
Phone (516) 295-1015

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138505NYMDOtolaryngology/Facial Plastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699885483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 72ND AVE",
            "address_2": "SUITE 1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754946",
            "telephone_number": "718-261-9000",
            "fax_number": "718-268-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 72ND AVE",
            "address_2": "SUITE 1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754946",
            "telephone_number": "718-261-9000",
            "fax_number": "718-268-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSH",
        "first_name": "SHELDON",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "138505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00744234",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.