Individual provider Active NPI

Anzhelika R Shimunov, S.I.

  • Specialist
  • Jamaica, NY
National Provider Identifier
1003193715
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
8099 Surrey PL
Jamaica, NY 11432-1452
Phone
(917) 608-9514
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

8099 Surrey PL
Jamaica, NY 11432-1452

Mailing address

8099 Surrey PL
Jamaica, NY 11432-1452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1003193715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8099 SURREY PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8099 SURREY PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321452",
            "telephone_number": "917-608-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMUNOV",
        "first_name": "ANZHELIKA",
        "middle_name": "R",
        "credential": "S.I.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.