Individual provider Active NPI

David Shokrian, MD

  • Surgery Physician
  • Great Neck, NY
National Provider Identifier
1811253081
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
263932-1 Issued in NY
Practice address
9 Sinclair Dr
Great Neck, NY 11024-1621
Phone
(516) 209-7400
NPI assigned
Apr 2, 2012
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 263932-1 NY Primary

Addresses

Primary practice location

9 Sinclair Dr
Great Neck, NY 11024-1621

Mailing address

9 Sinclair Dr
Great Neck, NY 11024-1621
Phone (516) 209-7400

Other identifiers 1

IdentifierTypeStateIssuer
1811253081MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20141118001887 AL Practitioner - Plastic and Reconstructive Surgery 3476796830 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263932-1NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC CurrentSince Aug 21, 2014 Accepting new patients
American Family Care, LLC CurrentSince Aug 21, 2014 Accepting new patients
American Family Care, LLC Current Accepting new patients
Millennial Plastic Surgery PLLC Current Accepting new patients

Locations

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

Organizations & group practices 5

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1811253081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SINCLAIR DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241621",
            "telephone_number": "516-209-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SINCLAIR DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241621",
            "telephone_number": "516-209-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOKRIAN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "263932-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811253081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.