Individual provider Active NPI

Janhavi H Shirali, M.D.

  • Ophthalmology Physician
  • Fresh Meadows, NY
National Provider Identifier
1760746697
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
276698 Issued in NY
Practice address
19213 Union Tpke
Fresh Meadows, NY 11366-1865
Phone
(718) 468-9800
Fax
(718) 468-0600
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 276698 NY
Ophthalmology Physician 207W00000X 276698 NY Primary

Addresses

Primary practice location

19213 Union Tpke
Fresh Meadows, NY 11366-1865

Mailing address

19213 Union Tpke
Fresh Meadows, NY 11366-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161122000384 DC Practitioner - Ophthalmology 4587943196 Reassigns benefits to 1 organization
I20180221000276 NY Practitioner - Ophthalmology 4587943196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of Ny Upstate Medical University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Feb 1, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Feb 1, 2024 Accepting new patients
Children's Hospital CurrentSince Sep 27, 2016 Accepting new patients
Children's Hospital CurrentSince Sep 27, 2016 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Children's Hospital Current Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: jshirali110437@direct.optum.com
  • Direct secure messaging: janhavi.shirali@direct.stonybrookmedicine.edu

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1760746697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19213 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19213 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661865",
            "telephone_number": "718-468-9800",
            "fax_number": "718-468-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRALI",
        "first_name": "JANHAVI",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NY",
            "license": "276698",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "276698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.