Active NPI
Shadi Seraji, MD
- Gynecology Physician
- Lynbrook, NY
National Provider Identifier
1881041127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 305809
- Practice address
- 130 Merrick Rd
Lynbrook, NY 11563-2740 - Phone
- (516) 596-7600
- NPI assigned
- May 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Gynecology Physician | 207VG0400X | 305809 | NY | Primary |
Addresses
Primary practice location
130 Merrick Rd
Lynbrook, NY 11563-2740
Mailing address
130 Merrick Rd
Lynbrook, NY 11563-2740
Phone (516) 596-7600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881041127 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sseraji362422@nyumc.direct-ci.com |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
488 Great Neck Rd
FL 3
Great Neck, NY 11021-4315
Phone (516) 482-6747
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305809 | NY | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
488 Great Neck Rd
Fl 3
Great Neck, NY 11021
Phone (516) 466-5222
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1881041127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 MERRICK RD",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115632740",
"telephone_number": "516-596-7600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 MERRICK RD",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115632740",
"telephone_number": "516-596-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERAJI",
"first_name": "SHADI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-17",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NY",
"license": "305809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1881041127",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sseraji362422@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "130 Merrick Rd",
"city": "Lynbrook",
"state": "NY",
"country_code": "US",
"postal_code": "115632740",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lynbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.