SHAKEEL MODAK MBBS
NPI 1063483535
Pediatrics in New York, NY
About Shakeel Modak Mbbs NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAKEEL MODAK MBBS (NPI 1063483535) is an individual pediatrics provider in New York, New York, licensed in New York (222483) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1988).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shakeel Modak Mbbs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Shakeel Modak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 220 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10021
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 Shakeel Modak's NPI number?
The NPI number for Shakeel Modak is 1063483535. It was assigned to this individual provider in the NPPES registry on January 31, 2006.
Where is Shakeel Modak located?
Shakeel Modak practices at 1275 York Ave, New York, NY 10021. The listed phone number is (212) 639-7623.
What is Shakeel Modak's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Shakeel Modak enrolled in Medicare?
Yes. Shakeel Modak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Shakeel Modak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shakeel Modak reassigns Medicare benefits to Memorial Pediatric Group (New York, NY). The 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 Shakeel Modak'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 Shakeel Modak was last updated on April 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.
# Shakeel Modak, MBBS · NPI 1063483535
Pediatrics physician in New York, New York. Individual provider, active in the CMS NPPES registry since January 31, 2006.
## Identity
- **NPI:** 1063483535 (Entity type: Individual)
- **Enumerated:** January 31, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 222483 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1275 YORK AVE, New York, NY 10021-6007
- **Phone:** (212) 639-7623
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Memorial Pediatric Group (NPI 1750352381, New York, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1988
## Record status
- **NPPES last updated:** April 26, 2012
- **Other identifiers:** Medicare UPIN H55480; Medicare ID-Type Unspecified 489X41
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Source: [NPI Profile](https://npiprofile.com/npi/1063483535) · Data from the CMS NPPES public registry.