Individual provider Active NPI

Sherly Shaji Varghese

  • Adult Health Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1043847072
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309569 Issued in NY
Practice address
541 Beech St
New Hyde Park, NY 11040-3825
Phone
(516) 326-7525
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309569 NY Primary

Addresses

Primary practice location

541 Beech St
New Hyde Park, NY 11040-3825

Mailing address

541 Beech St
New Hyde Park, NY 11040-3825
Phone (646) 915-6939

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL NewHydePark Health Information Exchange (HIE)
CONNECT URL NewHydePark Health Information Exchange (HIE)
CONNECT URL NewHydePark Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211027002026 NY Practitioner - Nurse Practitioner 6103214960 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F309569NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Nov 1, 2021 Accepting new patients
Jamaica Hospital CurrentSince Nov 1, 2021 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Essen Medical Associates, PC CurrentSince Aug 21, 2021 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Aug 21, 2021 Accepting new patients
Lefferts Medical Associates PC CurrentSince Feb 1, 2022 Accepting new patients
Essen Medical Associates,PC CurrentSince Aug 21, 2021 Accepting new patients
Instant Medical Care, PC PastSince Apr 11, 2021 Accepting new patients

Locations

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

18215 Hillside Ave
Jamaica, NY 11432
Phone (718) 262-8651

26619 Union Tpke
New Hyde Park, NY 11040
Phone (718) 347-0434

27005 76th Ave
North New Hyde Pk, NY 11040

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: svarghese4169@direct.medisys.org

Organizations & group practices 8

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1043847072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 BEECH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403825",
            "telephone_number": "646-915-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 BEECH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403825",
            "telephone_number": "516-326-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "SHERLY",
        "middle_name": "SHAJI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NewHydePark",
            "affiliation": "N",
            "endpointDescription": "home",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "541 Beech St",
            "city": "New Hyde Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110403825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NewHydePark",
            "affiliation": "N",
            "endpointDescription": "home",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "541 Beech St",
            "city": "New Hyde Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110403825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NewHydePark",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "541 Beech St",
            "city": "New Hyde Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110403825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.