Individual provider Active NPI

Sanjay Shetty, M.D.

  • Emergency Medicine Physician
  • Oceanside, NY
National Provider Identifier
1770510893
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
223773 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3900
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME89594 FL
Emergency Medicine Physician 207P00000X 223773 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

70 Harbor LN
Massapequa Park, NY 11762-3902
Phone (917) 589-5109

Other identifiers 2

IdentifierTypeStateIssuer
269588000MedicaidFL
43213OtherFLBLUE SHIELD OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, LA2 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
I20090826000387 NY Practitioner - Emergency Medicine 2567449655 Reassigns benefits to 6 organizations
I20230707003638 LA Practitioner - Emergency Medicine 2567449655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 9234101221, 96 clinicians
Mercy Medical CenterGroup PAC ID 4082518006, 83 clinicians
St. Joseph HospitalGroup PAC ID 1254222938, 101 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1353
Phone (516) 562-6000

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-3428

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.1 of 100Reported as individual
Quality
88.62
Improvement activities
0
Cost
77.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME89594FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Physician Associates, LLC Emergency Medicine CurrentSince Feb 4, 2023 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Feb 12, 2021 Accepting new patients
East Baton Rouge Emergency Physicians Group, LLC Emergency Medicine CurrentSince Apr 13, 2023 Accepting new patients
Shetty/Chirayil Medical, P.C. Current Accepting new patients
Mercy Medical Center Current Accepting new patients
Mercy Medical Center CurrentSince Feb 1, 2021 Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince Mar 1, 2023 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Blue Lotus Medical Wellness, P.C. Current Accepting new patients
Progressive Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 26, 2018 Accepting new patients
Professional Emergency Medicine Management -- Lake Charles LLC Emergency Medicine CurrentSince Feb 4, 2023 Accepting new patients
St. Joseph Hospital CurrentSince May 17, 2023 Accepting new patients
Venus Medical Arts, P.C. Current Accepting new patients
St. Francis Hospital Current Accepting new patients
Samaritan Emergency Medical Services, PC Emergency Medicine CurrentSince Feb 15, 2014 Accepting new patients
St. Francis Hospital CurrentSince Mar 1, 2023 Accepting new patients
Island Emergency Medical Services, P.C. Emergency Medicine Past Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

5000 Hennessy Blvd
Ste B
Baton Rouge, LA 70808

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

5000 Odonavan Blvd
Walker, LA 70785
Phone (225) 214-4200

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1770510893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117623902",
            "telephone_number": "917-589-5109",
            "fax_number": "516-799-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME89594",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "223773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269588000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FL",
            "identifier": "43213",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.