Organization Active NPI

Alla Seldina Family Health NP PC

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1053917708
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
ALLA SELDINA FAMILY HEALTH NP PC
Practice address
2305 Hylan Blvd
Staten Island, NY 10306-3231
Phone
(718) 667-0297
Fax
(718) 667-1945
NPI assigned
Dec 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Lyudmila Rozenberg
Title
Credentialing Specialist
Phone
(718) 667-0297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

2305 Hylan Blvd
Staten Island, NY 10306-3231

Mailing address

2305 Hylan Blvd
Staten Island, NY 10306-3231
Phone (718) 667-0297

Other identifiers 1

IdentifierTypeStateIssuer
05184818MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL practicefusion Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210123000069 NY Part B Supplier - Clinic/Group Practice 3476967944 Receives reassigned benefits from 1 practitioner
Practice locations: Staten Island, NY
O20210407001131 FL Part B Supplier - Clinic/Group Practice 3476967944 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1053917708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063231",
            "telephone_number": "718-667-0297",
            "fax_number": "718-667-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063231",
            "telephone_number": "718-667-0297",
            "fax_number": "718-667-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLA SELDINA FAMILY HEALTH NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "ROZENBERG",
        "authorized_official_first_name": "LYUDMILA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "718-667-0297"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05184818",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "practicefusion",
            "affiliation": "N",
            "endpointDescription": "electronic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2305 Hylan Blvd",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103063231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.