Individual provider Active NPI

Libbat-Tzion Idit Shaham, M.D.

  • Family Medicine Physician
  • Jamaica, NY
National Provider Identifier
1740686351
Registry record updated Nov 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
277649 Issued in NY
Practice address
8900 Van Wyck Expy
Dept of Family Medicine
Jamaica, NY 11418-2832
Phone
(718) 206-6748
NPI assigned
Nov 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 277649 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Dept of Family Medicine
Jamaica, NY 11418-2832

Mailing address

8900 Van Wyck Expy
Dept of Family Medicine
Jamaica, NY 11418-2832

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
I20151119001651 NY Practitioner - Family Practice 8325348535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Office of Manhattan PLLCGroup PAC ID 8426158833, 34 clinicians

Practice addresses (Care Compare)

112 W 72ND St
Suite a
New York, NY 10023-3305
Phone (212) 223-0349

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277649NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office of Manhattan PLLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

112 W 72nd St
Ste A
New York, NY 10023
Phone (212) 223-0349

201 E 65th St
New York, NY 10065
Phone (212) 879-4700

112 W 72nd St
New York, NY 10023
Phone (212) 223-0349

112 W 72nd St
#A
New York, NY 10023
Phone (212) 223-0349

Organizations & group practices 1

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": "1415404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415404800000",
    "number": "1740686351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "DEPT OF FAMILY MEDICINE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "DEPT OF FAMILY MEDICINE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "718-206-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAM",
        "first_name": "LIBBAT-TZION",
        "middle_name": "IDIT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-08",
        "last_updated": "2014-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "277649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.