NPIMap

Individual provider Active NPI

Ghazanfar W Haidery, MD

  • Family Medicine Physician
  • Glen Head, NY
National Provider Identifier
1801974159
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210618 Issued in NY
Practice address
997 Glen Cove Ave
Glen Head, NY 11545
Phone
(516) 676-1500
Fax
(516) 759-5946
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210618 NY Primary

Addresses

Primary practice location

997 Glen Cove Ave
Glen Head, NY 11545

Mailing address

26 George Street
Roslyn Heights, NY 11577
Phone (516) 676-1500

Other identifiers 2

IdentifierTypeStateIssuer
179962POtherHP
P1127871OtherOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707001010 NY Practitioner - Family PracticePractitioner - Geriatric Medicine 4082650312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Medical PCGroup PAC ID 0143610600, 93 clinicians

Practice addresses (Care Compare)

6136 170TH St
Fresh Meadows, NY 11365-1900
Phone (718) 709-0940

997 Glen Cove Ave
Suite 2
Glen Head, NY 11545-1593
Phone (516) 676-1500

Hospital & facility affiliations

  • Extended Home Care Home health agency, Brooklyn, NY, CCN 337414
  • Tender Loving Care, an Amedisys Company Home health agency, Carle Place, NY, CCN 337143
  • Centerwell Home Health Home health agency, Westbury, NY, CCN 337289
  • Emerest Home Health Care of Long Island Home health agency, Flushing, NY, CCN 337189
  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Hospice Care of Long Island, Queens, South Shore Hospice, Woodbury, NY, CCN 331532
  • Hospice of New York, LLC Hospice, Long Island City, NY, CCN 331560
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ghazanfar W. Haidery MD PC Family Medicine CurrentSince Jan 4, 2000 Accepting new patients
My Medical PC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Peyman Younesi MD PLLC PastSince Aug 1, 2024 Accepting new patients

Locations

3438 Bell Blvd
Ste 301
Bayside, NY 11361

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

997 Glen Cove Ave
Glen Head, NY 11545
Phone (516) 674-9144

997 Glen Cove Ave
Ste 2
Glen Head, NY 11545
Phone (516) 676-1500

6995 Queens Midtown Expy
Maspeth, NY 11378
Phone (718) 429-2200

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1801974159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GEORGE STREET",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "11577",
            "telephone_number": "516-676-1500",
            "fax_number": "516-676-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-676-1500",
            "fax_number": "516-759-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDERY",
        "first_name": "GHAZANFAR",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HP",
            "identifier": "179962P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1127871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

Verify at the official NPI Registry.