Individual provider Active NPI

Shanice Mann, FNP, RN

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1053771642
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355002 Issued in NY
Practice address
2094 Pitkin Ave
Brooklyn, NY 11207-3509
Phone
(844) 692-4692
NPI assigned
Feb 25, 2016
Last updated
Aug 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355002 NY Primary
Registered Nurse 163W00000X 708381 NY

Addresses

Primary practice location

2094 Pitkin Ave
Brooklyn, NY 11207-3509

Mailing address

2094 Pitkin Ave
Brooklyn, NY 11207-3509
Phone (844) 692-4692

Other practice location 1

3632 Nostrand Ave
Brooklyn, NY 11229-5305
Phone (347) 261-3569

Other identifiers 1

IdentifierTypeStateIssuer
708381MedicaidNY

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
I20250509001020 NY Practitioner - Nurse Practitioner 8426575788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2094 Pitkin Ave
Brooklyn, NY 11207-3509
Phone (718) 388-5889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
708381NYMDRegistered Nurse
355002NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Mar 3, 2025 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 3, 2025 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

2094 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 240-0400

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

227 Madison St
New York, NY 10002
Phone (212) 238-7000

50 Water St
Fl 3
New York, NY 10004

Networks

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

Interoperability endpoints

  • Direct secure messaging: smann4755452@nychhc.direct-ci.com

Organizations & group practices 4

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1053771642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112073509",
            "telephone_number": "844-692-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112073509",
            "telephone_number": "844-692-4692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3632 Nostrand Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112295305",
            "country_code": "US",
            "telephone_number": "347-261-3569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "SHANICE",
        "credential": "FNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355002",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "708381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "708381",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.