Shawn Khodadadian, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

244392 Issued in NY

Practice address

983 Park Ave
Ste 1D
New York, NY 10028-0808

Phone

(212) 427-8761

Fax

(212) 427-8762

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Midtown Endoscopy & Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
  • NPI 1073380853
  NPD (past) Authorized official
• Gastrointestinal Care of Long Island PLLC

  dba Allied Digestive Health Medical Group of New York

  • Gastroenterology Physician
  • Massapequa, NY
  • NPI 1265571863
  NPD (past)
• Madison Physician Practice PC

  • Adult Medicine Physician
  • New York, NY
  • NPI 1194206441
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1952505018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280808",
            "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": "983 PARK AVE",
            "address_2": "STE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280808",
            "telephone_number": "212-427-8761",
            "fax_number": "212-427-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODADADIAN",
        "first_name": "SHAWN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "244392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• May Kho
• Khoai Psychotherapy, LCSW
• Kashyar Khodabakhsh, M.D.
• Rachel Khodadadian, M.D.
• Saba Khodadadian, O.D,
• Gohar Khodadoost, DMD
• Kiana Khodadoostan Shahraki, DDS
• Iman Khodarahmi, MD
• Valeriya Khodatovych
• Daniel Khodorkovsky, DMD

• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.