Individual provider Active NPI

Shehla Shabnam, M.D.

  • Obstetrics & Gynecology Physician
  • Dix Hills, NY
National Provider Identifier
1730332420
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
250524 Issued in NY
Practice address
1036 Commack Rd
Dix Hills
Dix Hills, NY 11746-8210
Phone
(631) 940-7017
Fax
(631) 940-7018
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 250524 NY Primary

Addresses

Primary practice location

1036 Commack Rd
Dix Hills
Dix Hills, NY 11746-8210

Mailing address

1036 Commack Rd
Dix Hills
Dix Hills, NY 11746-8210
Phone (631) 940-7017

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
I20091019000303 NY Practitioner - Obstetrics/Gynecology 1456498732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

136 3Rd Ave
Brentwood, NY 11717-4617
Phone (631) 940-7017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250524NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Jan 29, 2020 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
Noor Medical Care PLLC Obstetrics & Gynecology CurrentSince Jun 1, 2010 Accepting new patients
Nassau Health Care Corporation CurrentSince Jan 29, 2020 Accepting new patients

Locations

136 3rd Ave
Brentwood, NY 11717
Phone (347) 268-9125

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

Networks

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

Interoperability endpoints

  • Direct secure messaging: sshabnam@3457.mdlanddirect.com

Organizations & group practices 4

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1730332420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 COMMACK RD",
            "address_2": "DIX HILLS",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468210",
            "telephone_number": "631-940-7017",
            "fax_number": "631-940-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 COMMACK RD",
            "address_2": "DIX HILLS",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468210",
            "telephone_number": "631-940-7017",
            "fax_number": "631-940-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABNAM",
        "first_name": "SHEHLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "250524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.