Individual provider Active NPI

Shaheen Ara Alam, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1851659312
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
296829 Issued in NY
Practice address
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone
(718) 613-4931
NPI assigned
May 2, 2012
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 296829 NY Primary

Addresses

Primary practice location

1545 Atlantic Ave
Brooklyn, NY 11213-1122

Mailing address

6728 Utopia Pkwy Apt 2F
Fresh Meadows, NY 11365-3452
Phone (917) 238-4732

Other practice location 1

3000 Arlington Ave
Graduate Medical Education, MS 1050
Toledo, OH 43614-2595
Phone (419) 383-5695

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address salam205988@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201019002962 OH Practitioner - Psychiatry 8123448834 Reassigns benefits to 2 organizations
I20201223001880 NY Practitioner - Psychiatry 8123448834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

5700 Monroe St
Sylvania, OH 43560-2767
Phone (567) 585-0005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296829NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Oct 1, 2020 Accepting new patients
Doctor on Demand Professionals P C Psychiatry CurrentSince Mar 1, 2022 Accepting new patients
Interfaith Psychiatry Services, P.C. Psychiatry CurrentSince Aug 20, 2020 Accepting new patients
Promedica Central Physicians CurrentSince Oct 1, 2020 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

50 W Broad St
Ste 1330
Columbus, OH 43215
Phone (630) 320-6871

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

5800 Monroe St
Bldg G
Sylvania, OH 43560
Phone (419) 824-6350

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

3000 Arlington Ave
#1050
Toledo, OH 43614
Phone (419) 383-1940

Interoperability endpoints

  • Direct secure messaging: salam205988@direct.promedica.org
  • Direct secure messaging: salam205988@epicdirect.promedica.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.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1851659312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6728 UTOPIA PKWY APT 2F",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653452",
            "telephone_number": "917-238-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "718-613-4931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_2": "Graduate Medical Education, MS 1050",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-5695",
            "fax_number": "419-383-3031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALAM",
        "first_name": "SHAHEEN",
        "middle_name": "ARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2023-11-03",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "296829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "salam205988@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.