Individual provider Active NPI

Shahed Quraishi, M.D.

  • Pediatric Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1710920822
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
265308 Issued in NY
Practice address
374 Stockholm St
Brooklyn, NY 11237-4006
Phone
(718) 963-6551
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 265308 NY Primary

Addresses

Primary practice location

374 Stockholm St
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-6551

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
I20060418000681 NY Practitioner - Pediatric Medicine 4587673686 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265308NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Sep 1, 2016 Accepting new patients
Physicians of University Hospital, PC CurrentSince Sep 1, 2016 Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 23, 2014 Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 23, 2014 Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Mar 1, 2015 Accepting new patients
Wyckoff Heights Medical Center Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Dec 1, 2012 Accepting new patients
Wyckoff Medical Services, P C Past Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

110 Wyckoff Ave
Brooklyn, NY 11237
Phone (718) 486-4155

1411 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 907-4301

300 Community Dr
Plandome, NY 11030

6852 Fresh Pond Rd
Ridgewood, NY 11385
Phone (718) 381-7016

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

2460 Hylan Blvd
Staten Island, NY 10306
Phone (718) 226-5619

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: squraishi67666@northwell.direct-ci.com
  • Direct secure messaging: shahedquraishi@whmc.allscriptsdirect.net

Organizations & group practices 8

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1710920822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURAISHI",
        "first_name": "SHAHED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "265308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.