Individual provider Active NPI

Shala Sadiq

  • Physician Assistant
  • Flushing, NY
National Provider Identifier
1831518604
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017395 Issued in NY
Practice address
13519 62ND Rd
Flushing, NY 11367-1006
Phone
(917) 553-0386
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017395 NY Primary

Addresses

Primary practice location

13519 62ND Rd
Flushing, NY 11367-1006

Mailing address

13519 62ND Rd
Flushing, NY 11367-1006
Phone (917) 553-0386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103000261 NY Practitioner - Physician Assistant 6709007974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551

Hospital & facility affiliations

  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017395NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine CurrentSince Jan 4, 2020 Accepting new patients
Mount Sinai School of Medicine CurrentSince Jan 4, 2020 Accepting new patients

Locations

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

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

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 1

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1831518604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13519 62ND RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671006",
            "telephone_number": "917-553-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13519 62ND RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671006",
            "telephone_number": "917-553-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADIQ",
        "first_name": "SHALA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.