Individual provider Active NPI

Sheela Manoj Kurup, M.D.

  • Internal Medicine Physician
  • Queens Village, NY
National Provider Identifier
1013917863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
232733 Issued in NY
Practice address
Bernard Fineson Developmental Center
Hillside Complex
Queens Village, NY 11428-0507
Phone
(718) 217-4242
Fax
(718) 217-6068
NPI assigned
Jul 22, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 232733 NY Primary

Addresses

Primary practice location

Bernard Fineson Developmental Center
Hillside Complex
Queens Village, NY 11428-0507

Mailing address

24 Roy St
Elmont, NY 11003-4341
Phone (516) 437-5423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802001374 NY Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0042248767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Office of Mental Health Current Accepting new patients

Locations

998 Crooked Hill Rd
West Brentwood, NY 11717
Phone (631) 306-5732

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013917863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ROY ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034341",
            "telephone_number": "516-437-5423",
            "fax_number": "516-437-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BERNARD FINESON DEVELOPMENTAL CENTER",
            "address_2": "HILLSIDE COMPLEX",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114280507",
            "telephone_number": "718-217-4242",
            "fax_number": "718-217-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUP",
        "first_name": "SHEELA",
        "middle_name": "MANOJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "232733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.