Individual provider Active NPI

Shahid Nawaz, MD

  • Hematology & Oncology Physician
  • East Patchogue, NY
National Provider Identifier
1700880465
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
200023 Issued in NY
Practice address
285 Sills Rd BLDG 16
East Patchogue, NY 11772-4808
Phone
(631) 751-3000
Fax
(631) 509-6559
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 200023 NY Primary

Addresses

Primary practice location

285 Sills Rd BLDG 16
East Patchogue, NY 11772-4808

Mailing address

1500 Route 112 BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 751-3000

Other identifiers 1

IdentifierTypeStateIssuer
02490128MedicaidNY

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
I20040323000128 NY Practitioner - Hematology/OncologyPractitioner - Internal Medicine 1557252236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

285 Sills Rd
BLDG 16
East Patchogue, NY 11772-4808
Phone (631) 751-3000

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC Specialist CurrentSince Sep 1, 2003 Accepting new patients
North Shore Hematology Oncology Associates PC Hematology & Oncology PastSince Dec 15, 2024 Accepting new patients

Locations

285 Sills Rd
Bldg 16
East Patchogue, NY 11772
Phone (631) 758-7575

6118 190th St
Ste 217
Fresh Meadows, NY 11365

3111 New Hyde Park Rd
North New Hyde Pk, NY 11042
Phone (516) 365-6100

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

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

235 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 450-1200

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

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: snawaz504545@nyumc.direct-ci.com
  • Direct secure messaging: dnawaz65836@northwell.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1700880465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 4",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-751-3000",
            "fax_number": "315-096-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 16",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724808",
            "telephone_number": "631-751-3000",
            "fax_number": "631-509-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWAZ",
        "first_name": "SHAHID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "200023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02490128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.