Individual provider Active NPI

Zara Shahid Chaudhary, DMD

  • Dentist
  • Staten Island, NY
National Provider Identifier
1942795760
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060686 Issued in NY
Practice address
57 Bay St
Staten Island, NY 10301-2510
Phone
(855) 681-8700
NPI assigned
Jun 25, 2018
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 060686 NY Primary

Addresses

Primary practice location

57 Bay St
Staten Island, NY 10301-2510

Mailing address

57 Bay St
Staten Island, NY 10301-2510

Other practice location 1

800 Poly Pl
Brooklyn, NY 11209-7104
Phone (718) 836-6600

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014000857 NY Practitioner - Dentist 3375874985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Sep 6, 2019 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

57 Bay St
Staten Island, NY 10301
Phone (718) 226-3200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1942795760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012510",
            "telephone_number": "855-681-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Poly Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097104",
            "country_code": "US",
            "telephone_number": "718-836-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUDHARY",
        "first_name": "ZARA",
        "middle_name": "SHAHID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.