NPIMap

Individual provider Active NPI

Shidley Prophete I, MD

  • Family Medicine Physician
  • Plainview, NY
National Provider Identifier
1841751336
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
322627 Issued in NY
Practice address
888 Old Country Rd
Plainview, NY 11803-4914
Phone
(516) 719-3000
NPI assigned
Mar 27, 2019
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101279851 VA
Family Medicine Physician 207Q00000X 322627 NY Primary

Addresses

Primary practice location

888 Old Country Rd
Plainview, NY 11803-4914

Mailing address

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other practice location 1

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other practice location 2

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7586

Other practice location 3

7519 Hospital Dr
Gloucester, VA 23061-4178
Phone (804) 693-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027002379 NY Practitioner - Family Practice 4587010418 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians
Ulster Physician Medicine Services PCGroup PAC ID 8527563931, 72 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

68 Harris Bushville Rd
Monticello, NY 12701-3027
Phone (845) 794-3300

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 256-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hospital CurrentSince Mar 1, 2025 Accepting new patients
North Shore-Lij Medical PC Family Medicine CurrentSince Sep 5, 2023 Accepting new patients
Ulster Physician Medicine Services PC CurrentSince Oct 1, 2025 Accepting new patients
Central Suffolk Hosptial CurrentSince Mar 1, 2025 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

68 Harris Bushville Rd
Monticello, NY 12701
Phone (845) 897-6053

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Networks

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

Interoperability endpoints

  • Direct secure messaging: sprophete76987@direct.garnethealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1841751336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034914",
            "telephone_number": "516-719-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Elm and Carlton St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142630001",
            "country_code": "US",
            "telephone_number": "716-845-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107014006",
            "country_code": "US",
            "telephone_number": "914-378-7586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7519 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "VA",
            "postal_code": "230614178",
            "country_code": "US",
            "telephone_number": "804-693-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROPHETE",
        "first_name": "SHIDLEY",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101279851",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "322627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.