Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pedram Shadibakhsh, FNP

Individual provider Family Nurse Practitioner · NPI 1801408000

Pedram Shadibakhsh, FNP is a Nurse Practitioner in Brooklyn, New York. Qualified in 2019, 7 years ago. Practices with Ahava Medical and Rehabilitation Center, LLC, a 150-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2020
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1078 E 32nd St
Brooklyn, NY 11210-4131
Phone: (917) 450-2219
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 346452 (NY)

Record details

NPI number1801408000
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 19, 2020
Last updated in NPPESAugust 19, 2020
Certification dateAugust 19, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ahava Medical And Rehabilitation Center, Llc — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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