NPIMap

Individual provider Active NPI

Ghulamullah Shahzad, MD

  • Gastroenterology Physician
  • Fresh Meadows, NY
National Provider Identifier
1710128996
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
252160 Issued in NY
Practice address
19303 Union Tpke
Fresh Meadows, NY 11366
Phone
(516) 721-4648
Fax
(516) 717-3019
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 252160 NY Primary

Addresses

Primary practice location

19303 Union Tpke
Fresh Meadows, NY 11366

Mailing address

957 N 1St St
New Hyde Park, NY 11040-2821
Phone (516) 784-8331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100412000051 NY Practitioner - GastroenterologyPractitioner - Anesthesiology 8224164769 Reassigns benefits to 4 organizations
Practice locations: Whitestone, NY; New York, NY; Fresh Meadows, NY; Floral Park, NY; Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillside Polymedic Diagnostic and Treatment Center IncGroup PAC ID 5496977910, 8 clinicians
Intercity Gastroenterology P.CGroup PAC ID 4284049511, 2 clinicians

Practice addresses (Care Compare)

18730 Hillside Ave
Jamaica, NY 11432-3216
Phone (718) 264-1111

19303 Union Tpke
Fresh Meadows, NY 11366-1874
Phone (516) 721-4648

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy133
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
252160NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercity Gastroenterology P.C Gastroenterology CurrentSince Mar 5, 2021 Accepting new patients
Hillside Polymedic Diagnostic & Treatment Center Inc CurrentSince Sep 27, 2023 Accepting new patients
GS Medical Practice PLLC CurrentSince Sep 16, 2020 Accepting new patients
Ghulamullah Shahzad Medical PLLC Gastroenterology CurrentSince Aug 1, 2023 Accepting new patients
Hillside Polymedic P.C. Gastroenterology PastSince Sep 27, 2023 Accepting new patients

Locations

19303 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 721-4648

18730 Hillside Ave
Jamaica, NY 11432
Phone (718) 264-1111

1991 Marcus Ave
Ste M202
New Hyde Park, NY 11042
Phone (516) 204-4242

Networks

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

Interoperability endpoints

  • Direct secure messaging: gshahzad259458@nychhc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1710128996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 N 1ST ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402821",
            "telephone_number": "516-784-8331",
            "fax_number": "516-704-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19303 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11366",
            "telephone_number": "516-721-4648",
            "fax_number": "516-717-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHZAD",
        "first_name": "GHULAMULLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "252160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.