Individual provider Active NPI

Tatyana Shahova

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1033429188
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
081893 Issued in NY
Practice address
236 Neptune Ave
Brooklyn, NY 11235-6302
Phone
(718) 769-2698
Fax
(718) 943-7035
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 081893 NY Primary

Addresses

Primary practice location

236 Neptune Ave
Brooklyn, NY 11235-6302

Mailing address

3047 Brighton 14TH St FL 2
Brooklyn, NY 11235-5501
Phone (917) 544-5473

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170301001589 NY Practitioner - Clinical Social Worker 2466735311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3047 Brighton 14TH St
FL 2
Brooklyn, NY 11235-5501

335 Lenox Ave
New York, NY 10027-3703
Phone (917) 544-5473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081893NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children'S Services, Inc. CurrentSince Jan 24, 2017 Accepting new patients
Jewish Board of Family & Childrens Services Inc CurrentSince Jan 24, 2017 Accepting new patients
Confidential LCSW Services,P.C. CurrentSince Aug 1, 2020 Accepting new patients
Jewish Board of Family and Children'S Services, Inc Past Accepting new patients

Locations

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

1007 Quentin Rd
Brooklyn, NY 11223
Phone (718) 896-9090

938 Kings Hwy
Brooklyn, NY 11223
Phone (718) 998-3235

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

335 Lenox Ave
New York, NY 10027
Phone (646) 585-1515

9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1033429188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3047 BRIGHTON 14TH ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355501",
            "telephone_number": "917-544-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NEPTUNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356302",
            "telephone_number": "718-769-2698",
            "fax_number": "718-943-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHOVA",
        "first_name": "TATYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.