Individual provider Active NPI

Shaina Marie L Malagad, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1902391493
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022265 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 241-1653
Fax
(212) 289-6393
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 022265 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 241-1653

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114000560 NY Practitioner - Physician Assistant 5991239824 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022265NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 4, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 4, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1902391493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-1653",
            "fax_number": "212-289-6393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1468 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296508",
            "country_code": "US",
            "telephone_number": "212-241-1653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAGAD",
        "first_name": "SHAINA MARIE",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.