Individual provider Active NPI

Shiraz Sandhu, D.O.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1952566655
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-01510 Issued in NC
Practice address
894 Eastern Pkwy
Brooklyn, NY 11213-3618
Phone
(718) 774-6060
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 246230 NY
Internal Medicine Physician 207R00000X 2016-01510 NC Primary

Addresses

Primary practice location

894 Eastern Pkwy
Brooklyn, NY 11213-3618

Mailing address

566 Ruin Creek Rd
Henderson, NC 27536-5932
Phone (252) 436-1352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110613000107 NY Practitioner - NephrologyPractitioner - Internal Medicine 2961689328 Practice locations: Brooklyn, NY
I20160913002325 NC Practitioner - HospitalistPractitioner - NephrologyPractitioner - Internal Medicine 2961689328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Nephrology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Nov 9, 2020 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Apogee Medical Group North Carolina CurrentSince Jul 15, 2016 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Nov 9, 2020 Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Interoperability endpoints

  • Direct secure messaging: shiraz.sandhu@direct.davitaphysiciansolutions.com
  • Direct secure messaging: ssandhu321316@directhisp.wakemed.org

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 3

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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1952566655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365932",
            "telephone_number": "252-436-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112133618",
            "telephone_number": "718-774-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "SHIRAZ",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "246230",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-01510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.