Individual provider Active NPI

Ksenia Shusherina

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1053892430
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
7000 Austin St
Forest Hills, NY 11375
Phone
(917) 549-9999
NPI assigned
Aug 24, 2018
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 004424 NY
Case Manager/Care Coordinator 171M00000X
Specialist 174400000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

7000 Austin St
Forest Hills, NY 11375

Mailing address

7000 Austin St
Forest Hills, NY 11375-1022
Phone (917) 549-9999

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

State licenses

LicenseStateTypeSpecialty
004424NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Mand Inc. Behavior Analyst Current Accepting new patients

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": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1053892430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "917-549-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "917-549-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSHERINA",
        "first_name": "KSENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "004424",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.