Individual provider Active NPI

Mma Shukur, MSN, FNP-C, BSN, RN

  • Family Nurse Practitioner
  • Richmond Hill, NY
National Provider Identifier
1083168520
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
359476 Issued in NY
Practice address
11311 Jamaica Ave
Richmond Hill, NY 11418-2476
Phone
(718) 850-0009
NPI assigned
Aug 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 749721 NY
Family Nurse Practitioner 363LF0000X 359476 NY Primary

Addresses

Primary practice location

11311 Jamaica Ave
Richmond Hill, NY 11418-2476

Mailing address

11311 Jamaica Ave Apt 2
Jamaica, NY 11418-2476
Phone (718) 850-0009

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
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
749721NYMDRegistered Nurse
359476NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1471046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1083168520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 JAMAICA AVE APT 2",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182476",
            "telephone_number": "718-850-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182476",
            "telephone_number": "718-850-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKUR",
        "first_name": "MMA",
        "credential": "MSN, FNP-C, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-13",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "749721",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "359476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.