Organization Active NPI

Shalom Kieval MD PC

  • Ophthalmology Physician
  • Latham, NY
National Provider Identifier
1821316928
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SHALOM KIEVAL MD PC
Practice address
13 Sunset Dr.
Latham, NY 12110
Phone
(518) 218-1234
Fax
(518) 218-1237
NPI assigned
May 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Authorized official

Name
Shalom J. Kieval, MDNPI 1316048796
Title
Owner
Phone
(518) 218-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

13 Sunset Dr.
Latham, NY 12110

Mailing address

13 Sunset Dr.
Latham, NY 12110
Phone (518) 218-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000501 NY Part B Supplier - Clinic/Group Practice 8729118534 Receives reassigned benefits from 4 practitioners
Practice locations: Latham, NY

National Provider Directory

National Provider Directory

Locations

223 Great Oaks Blvd
Albany, NY 12203
Phone (518) 218-1234

13 Sunset Dr
Latham, NY 12110
Phone (518) 218-1234

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1821316928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SUNSET DR.",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-218-1234",
            "fax_number": "518-218-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 SUNSET DR.",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-218-1234",
            "fax_number": "518-218-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM KIEVAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "KIEVAL",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-218-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.