Individual provider Active NPI

Shabiah Colin Martin, M.D

  • Colon & Rectal Surgery Physician
  • Woodbury, NY
National Provider Identifier
1922487909
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
310132-01 Issued in NY
Practice address
321 Crossways Park Dr
Woodbury, NY 11797-2066
Phone
(631) 470-1450
Fax
(631) 470-1451
NPI assigned
May 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X 310132-01 NY Primary

Addresses

Primary practice location

321 Crossways Park Dr
Woodbury, NY 11797-2066

Mailing address

321 Crossways Park Dr
Woodbury, NY 11797-2066
Phone (631) 470-1450

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211217000086 NY Practitioner - Colorectal Surgery (Proctology) 5597156026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1175 Montauk Hwy
West Islip, NY 11795-4939
Phone (631) 470-1450

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Plainview Hospital Hospital, Plainview, NY, CCN 330331
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310132-01NYMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Single Specialty CurrentSince Oct 21, 2021 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 21, 2021 Accepting new patients
South Shore University Hospital Past Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

400 W Main St
Ste 301
Babylon, NY 11702
Phone (631) 470-1451

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

300 Community Dr
Plandome, NY 11030

222 E Middle Country Rd
Ste 211
Smithtown, NY 11787
Phone (631) 470-1451

1175 Montauk Hwy
West Islip, NY 11795
Phone (631) 265-4485

972 Brush Hollow Rd
Westbury, NY 11590

321 Crossways Park Dr
Ste B
Woodbury, NY 11797
Phone (631) 470-1450

321 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 405-7100

Networks

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

Interoperability endpoints

  • Direct secure messaging: smartin323845@northwell.direct-ci.com

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1432425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1922487909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972066",
            "telephone_number": "631-470-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972066",
            "telephone_number": "631-470-1450",
            "fax_number": "631-470-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHABIAH",
        "middle_name": "COLIN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-24",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "310132-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.