NORTH SHORE COMPLETE MEDICAL PC
NPI 1164042156
Internal Medicine - Cardiovascular Disease in Manhasset, NY
About North Shore Complete Medical Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTH SHORE COMPLETE MEDICAL PC (NPI 1164042156) is a healthcare organization registered as a cardiovascular disease in Manhasset, New York and active in the NPI registry since April 2020. The organization lists Omid Javdan, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
North Shore Complete Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to North Shore Complete Medical PC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 North Shore Complete Medical PC's NPI number?
The NPI number for North Shore Complete Medical PC is 1164042156. It was assigned to this organization in the NPPES registry on April 20, 2020.
Where is North Shore Complete Medical PC located?
North Shore Complete Medical PC is located at 300 Community Dr, Manhasset, NY 11030. The listed phone number is (516) 403-9104.
What is North Shore Complete Medical PC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.
Is North Shore Complete Medical PC enrolled in Medicare?
Yes. North Shore Complete Medical PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through North Shore Complete Medical PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to North Shore Complete Medical PC, in Cardiovascular Disease (Cardiology) and Nurse Practitioner. A 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 the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for North Shore Complete Medical PC was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# North Shore Complete Medical Pc · NPI 1164042156
Cardiovascular Disease organization in Manhasset, New York. Organization record, active in the CMS NPPES registry since April 20, 2020.
## Identity
- **NPI:** 1164042156 (Entity type: Organization)
- **Enumerated:** April 20, 2020
- **Primary specialty:** Internal Medicine - Cardiovascular Disease · taxonomy 207RC0000X
- **Organization subpart:** No
- **Authorized official:** Omid Javdan, MD
## Practice location
- **Address:** 300 COMMUNITY DR, Manhasset, NY 11030-3816
- **Phone:** (516) 403-9104
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Cardiovascular Disease (Cardiology) (1); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 20, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1164042156) · Data from the CMS NPPES public registry.