Individual provider Active NPI

Marina G Shtern, M.D.

  • Obstetrics & Gynecology Physician
  • Forest Hills, NY
National Provider Identifier
1093870388
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
212461 Issued in NY
Practice address
107 21 Queens Blvd
Suite 1
Forest Hills, NY 11375
Phone
(718) 520-0700
Fax
(718) 520-7180
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 212461 NY Primary

Addresses

Primary practice location

107 21 Queens Blvd
Suite 1
Forest Hills, NY 11375

Mailing address

39 Valley View Rd
Great Neck, NY 11021
Phone (516) 482-3035

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000397 NY Practitioner - Obstetrics/Gynecology 4385638741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
212461NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Mar 1, 2016 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Mar 1, 2016 Accepting new patients
Newyork-Presbyterian/Queens Obstetrics & Gynecology Past Accepting new patients
Anna Fieldman MD PC Obstetrics & Gynecology Past Accepting new patients

Locations

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Interoperability endpoints

  • Direct secure messaging: mgs9003@direct.nyp.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093870388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 VALLEY VIEW RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-482-3035",
            "fax_number": "516-482-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 21 QUEENS BLVD",
            "address_2": "SUITE 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-520-0700",
            "fax_number": "718-520-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTERN",
        "first_name": "MARINA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "212461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.