Individual provider Active NPI

Michelle Yangyang Shi, MD, DPT

  • Internal Medicine Physician
  • Manhasset, NY
National Provider Identifier
1770829897
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
317304 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-0100
NPI assigned
Dec 17, 2012
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 317304 NY Primary
Physical Therapist 225100000X 035761 NY

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

300 Community Dr
Manhasset, NY 11030-3816

Other practice location 1

13527 38th Ave Ste 368
Flushing, NY 11354-4449
Phone (929) 200-7198

Other identifiers 1

IdentifierTypeStateIssuer
5436026MedicaidNY

Other names 1

  • Yangyang Shi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in 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
I20140627002140 NY Practitioner - Physical Therapist in Private Practice 8527283894 Reassigns benefits to 3 organizations
I20230119002178 NY Practitioner - Internal Medicine 8527283894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035761NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jun 25, 2022 Accepting new patients
Excel in Motion Physical Therapy P.C. Physical Therapist CurrentSince Nov 1, 2018 Accepting new patients
New Dimensions Physical Therapy, PLLC Physical Therapist CurrentSince Jun 1, 2014 Accepting new patients

Locations

13527 38th Ave
Ste 368
Flushing, NY 11354
Phone (929) 200-7198

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

55 Lumber Rd
Ste 190
Roslyn, NY 11576
Phone (516) 304-5373

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 3

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": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1770829897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13527 38th Ave Ste 368",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113544449",
            "country_code": "US",
            "telephone_number": "929-200-7198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHI",
        "first_name": "MICHELLE",
        "middle_name": "YANGYANG",
        "name_prefix": "Dr.",
        "credential": "MD, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "317304",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5436026",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YANGYANG",
            "last_name": "SHI",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.