Organization Active NPI

Shahkoohi Medicine PC

  • Clinic/Center
  • Great Neck, NY
National Provider Identifier
1962267666
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SHAHKOOHI MEDICINE PC
Practice address
8 Fairfield Rd
Great Neck, NY 11024-1436
Phone
(917) 940-3016
NPI assigned
Feb 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Dr. Afshin Shahkoohi, MDNPI 1326198631
Title
President
Phone
(917) 940-3016

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

8 Fairfield Rd
Great Neck, NY 11024-1436

Mailing address

8 Fairfield Rd
Great Neck, NY 11024-1436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240412003103 NY Part B Supplier - Clinic/Group Practice 0941649784 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1962267666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FAIRFIELD RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FAIRFIELD RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241436",
            "telephone_number": "917-940-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHKOOHI MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "SHAHKOOHI",
        "authorized_official_first_name": "AFSHIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-940-3016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.