NPIMap

Individual provider Active NPI

Tariq A Sheikh, MD

  • Family Medicine Physician
  • Derby, NY
National Provider Identifier
1891799656
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233142 Issued in NY
Practice address
7060 Erie Rd
Suite 100
Derby, NY 14047-9430
Phone
(716) 947-0408
Fax
(716) 947-0413
NPI assigned
Jun 9, 2005
Last updated
Jun 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 233142 NY Primary

Addresses

Primary practice location

7060 Erie Rd
Suite 100
Derby, NY 14047-9430

Mailing address

7060 Erie Rd
Suite 100
Derby, NY 14047-9430
Phone (716) 947-0408

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
I20040816000064 NY Practitioner - Family Practice 2961475314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Family Medicine Assoc PCGroup PAC ID 8527031988, 3 clinicians

Practice addresses (Care Compare)

10626 Main St
North Collins, NY 14111-9550
Phone (716) 337-2422

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Family Medicine Assoc PC Family Medicine CurrentSince Jul 1, 2004 Accepting new patients
General Physician, PC PastSince Jul 1, 2004 Accepting new patients

Locations

7060 Erie Rd
Derby, NY 14047
Phone (716) 677-2273

7060 Erie Rd
Ste 100
Derby, NY 14047
Phone (716) 947-0408

12655 Seneca Rd
Irving, NY 14081
Phone (716) 517-5069

10626 Main St
North Collins, NY 14111
Phone (716) 337-2422

Interoperability endpoints

  • Direct secure messaging: tsheikh@lakeshorefamily.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1891799656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7060 ERIE RD",
            "address_2": "SUITE 100",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479430",
            "telephone_number": "716-947-0408",
            "fax_number": "716-947-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7060 ERIE RD",
            "address_2": "SUITE 100",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479430",
            "telephone_number": "716-947-0408",
            "fax_number": "716-947-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEIKH",
        "first_name": "TARIQ",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "233142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

Verify at the official NPI Registry.