NPIMap

Organization Active NPI

Rakesh Sharma Physician PC

  • Internal Medicine Physician
  • Lake Ronkonkoma, NY
National Provider Identifier
1831462464
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
161670 Issued in NY
Legal business name
RAKESH SHARMA PHYSICIAN PC
Practice address
122 Portion Rd
Suite 104
Lake Ronkonkoma, NY 11779-4174
Phone
(631) 588-8393
Fax
(631) 588-2312
NPI assigned
Feb 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Dr. Rakesh Sharma, M.D.
Title
Physician
Phone
(631) 588-8393

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 161670 NY Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X 161670 NY

Addresses

Primary practice location

122 Portion Rd
Suite 104
Lake Ronkonkoma, NY 11779-4174

Mailing address

122 Portion Rd
Suite 104
Lake Ronkonkoma, NY 11779-4174
Phone (631) 588-8393

Other identifiers 1

IdentifierTypeStateIssuer
01110154MedicaidNY

National Provider Directory

National Provider Directory

Locations

122 Portion Rd
Ste 104
Lake Ronkonkoma, NY 11779
Phone (631) 588-8393

360 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 588-0880

Practitioners & affiliated clinicians

Practitioners 8

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": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1831462464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PORTION RD",
            "address_2": "SUITE 104",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794174",
            "telephone_number": "631-588-8393",
            "fax_number": "631-588-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PORTION RD",
            "address_2": "SUITE 104",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794174",
            "telephone_number": "631-588-8393",
            "fax_number": "631-588-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAKESH SHARMA PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAKESH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-588-8393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "161670",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "161670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01110154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.