Active NPI
Ksenia Shusherina
- Specialist
- Forest Hills, NY
National Provider Identifier
1053892430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 7000 Austin St
Forest Hills, NY 11375 - Phone
- (917) 549-9999
- NPI assigned
- Aug 24, 2018
- Last updated
- Nov 3, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 004424 | NY | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New 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.