NPIMap

Organization Active NPI

Manhattan Gastroenterology P.C.

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1922396472
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MANHATTAN GASTROENTEROLOGY P.C.
Practice address
55 W 17TH St
New York, NY 10011-5513
Phone
(212) 427-8761
Fax
(212) 427-8762
NPI assigned
Jul 19, 2011
Last updated
Oct 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Authorized official

Name
Dr. Shawn Khodadadian, M.D.NPI 1952505018
Title
Owner
Phone
(646) 351-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Dermatology Physician 207N00000X
Internal Medicine Physician 207R00000X
Gastroenterology Physician 207RG0100X 244392 NY
Gastroenterology Physician 207RG0100X Primary
Gynecology Physician 207VG0400X
Podiatrist 213E00000X

Addresses

Primary practice location

55 W 17TH St
New York, NY 10011-5513

Mailing address

121 W 27TH St Ste 504
New York, NY 10001-6207
Phone (212) 427-8761

Other practice location 1

56 W 45th St Ste 802
New York, NY 10036-0385
Phone (646) 681-4306

Other practice location 2

983 Park Ave Ste 1D
New York, NY 10028-0808
Phone (212) 427-8761

Other identifiers 1

IdentifierTypeStateIssuer
A100252116OtherNYMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110818000476 NY Part B Supplier - Clinic/Group Practice 7719156207 Receives reassigned benefits from 19 practitioners
Practice locations: New York, NY; Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2165881Manhattan Gastroenterology983 Park Ave - Suite 1D, New York, NY 10028Certificate of waiverMar 26, 2027
33D2165882Manhattan Gastroenterology55 W 17TH Street, New York, NY 10011Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

121 W 27th St
New York, NY 10001

147 E 26th St
Ste 504
New York, NY 10010

80 Maiden Ln
Rm 1204
New York, NY 10038
Phone (212) 427-8761

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1922396472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W 27TH ST STE 504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016207",
            "telephone_number": "212-427-8761",
            "fax_number": "212-427-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115513",
            "telephone_number": "212-427-8761",
            "fax_number": "212-427-8762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 W 45th St Ste 802",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100360385",
            "country_code": "US",
            "telephone_number": "646-681-4306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "983 Park Ave Ste 1D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100280808",
            "country_code": "US",
            "telephone_number": "212-427-8761",
            "fax_number": "212-427-8762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MANHATTAN GASTROENTEROLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "KHODADADIAN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-351-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "244392",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A100252116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.