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SHERVIN SHADIANLOO M.D.
NPI 1053604694
Psychiatry & Neurology - Child & Adolescent Psychiatry in New York, NY

Active since May 16, 2011PECOS Enrolled
1123 BROADWAY STE 1117, NEW YORK, NY 10010(212) 253-0030 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 12, 2026, Jul 6, 2020, Jun 15, 2016 (3 updates tracked since 2016).

About Shervin Shadianloo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHERVIN SHADIANLOO M.D. (NPI 1053604694) is an individual child & adolescent psychiatry provider in New York, New York, licensed in New York (277220) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053604694
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameSHERVIN SHADIANLOOCredential: M.D.
Location Address1123 BROADWAY STE 1117New York, NY 10010-2007
Mailing Address1123 Broadway Ste 1117New York, NY 10010-2007 · (212) 253-0030
Phone(212) 253-0030
Sole ProprietorNo
Enumeration DateMay 16, 2011
Last NPPES UpdateMay 12, 20263 updates tracked since enumeration
NPPES CertifiedMay 12, 2026
✔ NPI 1053604694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Licenses✔ Licensed in NY · 277220✔ Licensed in CA · 141090✔ Licensed in NJ · 25MA11336700
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
1123 BROADWAY STE 1117, New York, NY 10010
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shervin Shadianloo M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Shervin Shadianloo reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Maimonides Department Of Psychiatry Fpp
7.2 mi
Psychiatry
4802 10TH AVE
Brooklyn, NY 11219
  • Reassigned Medicare billing, New York enrollment
  • 94 clinicians in this Medicare group
NPI 1376656710 (718) 283-8773
Maimonides Faculty Practice Plan
7.2 mi
Internal Medicine
4802 10TH AVE
Brooklyn, NY 11219
  • Reassigned Medicare billing, New York enrollment
  • 1,177 clinicians in this Medicare group
NPI 1053344846 (718) 283-8700
North Shore - Lij Medical PC
15 mi
Internal Medicine
270-05 76TH AVE
New Hyde Park, NY 11040
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1790043479 (516) 465-8089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OMIDVARI PSYCHIATRY P.C.
Psychiatry & Neurology (Psychiatry)
1123 BROADWAY STE 1117
NEW YORK, NY 10010
New York County (646) 874-9340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shervin Shadianloo's NPI number?

The NPI number for Shervin Shadianloo is 1053604694. It was assigned to this individual provider in the NPPES registry on May 16, 2011.

Where is Shervin Shadianloo located?

Shervin Shadianloo practices at 1123 Broadway Ste 1117, New York, NY 10010. The listed phone number is (212) 253-0030.

What is Shervin Shadianloo's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Shervin Shadianloo enrolled in Medicare?

Yes. Shervin Shadianloo is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shervin Shadianloo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shervin Shadianloo reassigns Medicare benefits to 3 organizations: Maimonides Department Of Psychiatry Fpp (Brooklyn, NY), Maimonides Faculty Practice Plan (Brooklyn, NY) and North Shore - Lij Medical PC (New Hyde Park, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shervin Shadianloo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shervin Shadianloo was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.