NPIMap

Individual provider Active NPI

Shahzad Zeb, RPA-C

  • Physician Assistant
  • Patchogue, NY
National Provider Identifier
1891817953
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011766-1 Issued in NY
Practice address
450 Waverly Ave
Patchogue, NY 11772-1555
Phone
(631) 204-6288
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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 011766-1 NY Primary

Addresses

Primary practice location

450 Waverly Ave
Patchogue, NY 11772-1555

Mailing address

101 Hospital Rd
Patchogue, NY 11772-4870

Other names 1

  • Shazad Zeb Professional name

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
I20041203000693 NY Practitioner - Physician Assistant 8921064783 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011766-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Talk of the Town Counseling LLC Current Accepting new patients
Singh'S Medical PC Current Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince May 1, 1986 Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince May 1, 1986 Accepting new patients
Sentra Laboratories Inc/ PastSince May 27, 2016 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients
Brookhaven Health Care Facility LLC Past Accepting new patients
Heartpath Cardiovascular Services, PLLC Past Accepting new patients
DME Medical Supplies Inc. PastSince May 31, 2011 Accepting new patients
Nursing Care Center at Medford Inc Past Accepting new patients

Locations

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

450 Waverly Ave
Ste 1
Patchogue, NY 11772
Phone (631) 307-9892

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1891817953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "631-204-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEB",
        "first_name": "SHAHZAD",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011766-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAZAD",
            "last_name": "ZEB",
            "credential": "RPA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.