Individual provider Active NPI

Fatima Altaf Shaik, M.D.

  • Cardiovascular Disease Physician
  • Flushing, NY
National Provider Identifier
1801214705
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA11053700 Issued in NJ
Practice address
5645 Main St
Flushing, NY 11355
Phone
(718) 670-1286
NPI assigned
Mar 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11053700 NJ
Cardiovascular Disease Physician 207RC0000X 25MA11053700 NJ Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355

Mailing address

5645 Main St
Flushing, NY 11355-5045

Other practice location 1

550 Newark Ave Ste 307
Jersey City, NJ 07306-1353
Phone (201) 418-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170808003801 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac Electrophysiology 4981975091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 960-6205

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-6392

Hospital & facility affiliations

  • St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11053700NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC CurrentSince Mar 20, 2024 Accepting new patients
Harlem Medical Associates PC CurrentSince Aug 21, 2017 Accepting new patients
Advanced Garden State Cardiology LLC Cardiovascular Disease CurrentSince Mar 1, 2023 Accepting new patients
SBH Physicians, PC Internal Medicine CurrentSince Mar 20, 2024 Accepting new patients

Locations

550 Newark Ave
Ste 307
Jersey City, NJ 07306
Phone (201) 418-9111

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGAICD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1801214705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-670-1286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Newark Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073061353",
            "country_code": "US",
            "telephone_number": "201-418-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAIK",
        "first_name": "FATIMA",
        "middle_name": "ALTAF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11053700",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA11053700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.