Organization Active NPI

Hillside Infectious Disease Consulting PLLC

  • Medical Specialty Clinic/Center
  • New Hyde Park, NY
National Provider Identifier
1831394469
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
230853 Issued in NY
Legal business name
HILLSIDE INFECTIOUS DISEASE CONSULTING PLLC
Practice address
1575 Hillside Ave Ste 100a
New Hyde Park, NY 11040-2501
Phone
(516) 833-7469
Fax
(516) 833-7470
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Dr. Saira K Shahab, M.D.NPI 1144271784
Title
Sole Proprietor
Phone
(516) 270-4742

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
Medical Specialty Clinic/Center 261QM2500X 230853 NY Primary

Addresses

Primary practice location

1575 Hillside Ave Ste 100a
New Hyde Park, NY 11040-2501

Mailing address

332 Bryn Mawr Rd
New Hyde Park, NY 11040-3509
Phone (516) 270-4742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091218000015 NY Part B Supplier - Clinic/Group Practice 5799886560 Receives reassigned benefits from 1 practitioner
Practice locations: Far Rockaway, NY; Glen Oaks, NY; Rockaway Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1831394469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 BRYN MAWR RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403509",
            "telephone_number": "516-270-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE STE 100A",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-833-7469",
            "fax_number": "516-833-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE INFECTIOUS DISEASE CONSULTING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "SHAHAB",
        "authorized_official_first_name": "SAIRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "516-270-4742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "230853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.