Active NPI
Shahbanoo Ghaffari Zandi, N.P
- Adult Health Nurse Practitioner
- Champlain, NY
National Provider Identifier
1962706804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 305524
- Practice address
- 481 Route 11
Champlain, NY 12919-0000 - Phone
- (518) 298-2691
- Fax
- (518) 298-8241
- NPI assigned
- Jan 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Plattsburgh, NY
- NPI 1841565686
-
- Primary Care Clinic/Center
- Castle Rock, CO
- NPI 1639529738
-
- Family Medicine Physician
- Plattsburgh, NY
- NPI 1780607085
-
- Primary Care Clinic/Center
- Champlain, NY
- NPI 1245285170
-
- Primary Care Clinic/Center
- Salem, NY
- NPI 1982417119
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110427000845 | NY | Practitioner - Nurse Practitioner | 0446435986 | Reassigns benefits to 1 organization |
| I20220405000879 | CO | Practitioner - Nurse Practitioner | 0446435986 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Richard J D'Amico DO PC | Current |
Accepting new patients | |
| Hudson Headwaters Health Network | Past | Accepting new patients | |
| Hudson Headwaters Health Network | Past | Accepting new patients |
Locations
74 Margaret St
Plattsburgh, NY 12901
Phone (518) 324-3074
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 305524 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
481 Route 11
Champlain, NY 12919-0000
Mailing address
74 Margaret St
Plattsburgh, NY 12901-2925
Phone (518) 562-2369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 13, 2016.
{
"created_epoch": "1294358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481587200000",
"number": "1962706804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 MARGARET ST",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129012925",
"telephone_number": "518-562-2369",
"fax_number": "518-562-2263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "481 ROUTE 11",
"city": "CHAMPLAIN",
"state": "NY",
"postal_code": "129190000",
"telephone_number": "518-298-2691",
"fax_number": "518-298-8241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAFFARI ZANDI",
"first_name": "SHAHBANOO",
"credential": "N.P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-07",
"last_updated": "2016-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "305524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Champlain, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.