Ismail Medicine, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ISMAIL MEDICINE, PLLC

Doing business as

The Alexandre Centre for Children's Health

Practice address

8016 E Genesee St
Fayetteville, NY 13066-9692

Phone

(315) 569-1612

NPI assigned

Aug 28, 2024

Organization subpart

No

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

Authorized official

Name

Shareen Ismail, MDNPI 1417158130

Title

Medical Director

Phone

(315) 569-1612

Specialties & licenses 15

Addresses

Other names 1

• The Alexandre Centre for Children's Health Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shareen Ismail, M.D.

  • Pediatrics Physician
  • Fayetteville, NY
  • NPI 1417158130
  NPD Authorized official

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1770317166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8016 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130669692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8016 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130669692",
            "telephone_number": "315-569-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMAIL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "SHAREEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "315-569-1612",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2278P3900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified, Neonatal/Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Alexandre Centre for Children's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Sarah Hogan
• Melinda Holmes, LMT
• Anna Hsu
• Lynne A. Humphrey, MD.
• Justin Iorio, M.D.
• Shareen Ismail, M.D.
• Stephen J Jackowski, RPA
• Cynthia Jackson, M.D.
• James C Prezzano MD PLLC
• Alexis James, LMHC

• Pediatrics Physician in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.