Organization Active NPI

New Shore Medical Health PC

  • Internal Medicine Physician
  • Saint Albans, NY
National Provider Identifier
1922848316
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NEW SHORE MEDICAL HEALTH PC
Practice address
13421 Springfield Blvd
Saint Albans, NY 11413-1448
Phone
(717) 716-7107
NPI assigned
May 31, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Michelle MorrisNPI 1891189015
Title
Owner
Phone
(717) 716-7107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

13421 Springfield Blvd
Saint Albans, NY 11413-1448

Mailing address

354 Hutchinson Ave
Mount Vernon, NY 10553-1810
Phone (717) 716-7107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240814001519 NY Part B Supplier - Clinic/Group Practice 3476091075 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Vernon, NY; Saint Albans, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1922848316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 HUTCHINSON AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531810",
            "telephone_number": "717-716-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13421 SPRINGFIELD BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114131448",
            "telephone_number": "717-716-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SHORE MEDICAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-716-7107"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.