Individual provider Active NPI

Shahrzad Assadzadeh Dilmaghani, DPM

  • Foot & Ankle Surgery Podiatrist
  • Northport, NY
National Provider Identifier
1740792811
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P06200 Issued in NY
Practice address
79 Middleville Rd
Northport, NY 11768-2200
Phone
(631) 261-4400
Fax
(631) 266-6050
NPI assigned
Oct 30, 2017
Last updated
Oct 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P06200 NY Primary

Addresses

Primary practice location

79 Middleville Rd
Northport, NY 11768-2200

Mailing address

23 Sherwood Gate
Oyster Bay, NY 11771-3805
Phone (516) 404-7977

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716000475 NY Practitioner - Podiatry 9234553884 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P06200NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Forward Podiatry PC CurrentSince Apr 15, 2022 Accepting new patients
Pulse Cardiology PLLC CurrentSince Nov 4, 2025 Accepting new patients
Ronkonkoma Medical Care PLLC CurrentSince Nov 4, 2025 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 1, 2025 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 1, 2025 Accepting new patients
Foot Forward Podiatry, LLC Foot & Ankle Surgery Past Accepting new patients
Robert J. Gottlieb, DPM, PC Foot & Ankle Surgery Past Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

9815 Horace Harding Expy
Ste 1L
Corona, NY 11368
Phone (516) 243-9777

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

299 Ronkonkoma Ave
Ronkonkoma, NY 11779
Phone (516) 243-9777

918 James St
#13282
Syracuse, NY 13203

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

94 South Ave
Harrisonburg, VA 22801
Phone (276) 638-8701

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1740792811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHERWOOD GATE",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117713805",
            "telephone_number": "516-404-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILMAGHANI",
        "first_name": "SHAHRZAD",
        "middle_name": "ASSADZADEH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "P06200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.