Shideh Shafinoori Maybody, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

244985 Issued in NY

Practice address

3016 30TH Dr
Long Island City, NY 11102-1874

Phone

(718) 626-0670

Fax

(718) 626-0694

NPI assigned

Dec 28, 2005

Last updated

Dec 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: shidehmaybody@nslijmedgr.allscriptsdirect.net

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1972580215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 YORK AVE APT 3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657945",
            "telephone_number": "718-626-0670",
            "fax_number": "718-626-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 30TH DR",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111021874",
            "telephone_number": "718-626-0670",
            "fax_number": "718-626-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBODY",
        "first_name": "SHIDEH",
        "middle_name": "SHAFINOORI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "244985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02956889",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64070725",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxim of New York, LLC (Maxim Healthcare Services)
• Juliane Maxwald-Shrey, MA, LP, CASAC
• Emily Maxwell, OTR/L
• May Healthy Kids Pediatric, P.C
• Madeleine Marie May, PA-C
• Angela V Mazza, RN
• Lisa Mazza, PA
• Camille Lauren Mazzaro, REGISTERED NURSE
• Judith Ann McAllister, MS, LCSW-R
• Robert Derek McAllister, RN

• Pediatrics Physician in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.