Shahrzad Assadzadeh Dilmaghani, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Northport, NY
NPI 1740792811 · NPPES record last updated Oct 30, 2017
Key facts
- NPI
- 1740792811
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- P06200 (NY)
- Practice address
- 79 Middleville Rd
Northport, NY 11768-2200 - Phone
- (631) 261-4400
- Fax
- (631) 266-6050
- NPI assigned
- Oct 30, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- 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 Inc
Practice addresses (Care Compare)
445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200716000475 | NY | Practitioner - Podiatry | 9234553884 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P06200 | NY | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronkonkoma Medical Care PLLC | Current |
Accepting new patients | |
| Parcare Community Health Network Inc | Current |
Accepting new patients | |
| Parcare Community Health Network Inc | Current |
Accepting new patients | |
| Foot Forward Podiatry PC | Current |
Accepting new patients | |
| Pulse Cardiology PLLC | Current |
Accepting new patients | |
| Robert J. Gottlieb, DPM, PC | Foot & Ankle Surgery | Past | Accepting new patients |
| Foot Forward Podiatry, LLC | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | P06200 | NY | Yes |
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
Other providers in Northport, NY
- James J Diaz
- Paul Diggs
- Leah M Digianni
- Stephanie Marion Digiorgio
- Patricia Irene Dillon
- Gianna Dipietro
- Candice Distefano
- Jason Distefano
- Troy Everett Dixon
- Barbara M Donahue
All providers in Northport, NY · Foot & Ankle Surgery Podiatrist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.