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

Individual provider Pediatrics Physician · NPI 1063483535

Shakeel Modak, MBBS is a Pediatric Medicine in New York, New York. Qualified in 1988, 38 years ago. Practices with Memorial Pediatric Group, a 39-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
38
Licensed in
NY
In the registry since
2006
What do these letters mean?
MBBS — Bachelor of Medicine, Bachelor of Surgery
The medical degree awarded in the UK, India and many Commonwealth countries; equivalent to an MD.

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Practice location Address checks out

1275 York Ave
New York, NY 10021-6007
Phone: (212) 639-7623
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 222483 (NY)

Record details

NPI number1063483535
Entity typeIndividual (Type 1)
GenderMale
Credentials MBBS
Sole proprietorNo
NPI enumeratedJanuary 31, 2006
Last updated in NPPESApril 26, 2012

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Memorial Pediatric Group — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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