Individual provider Active NPI

Shirina Ally

  • Psychiatric/Mental Health Nurse Practitioner
  • Cambria Heights, NY
National Provider Identifier
1114219011
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403212 Issued in NY
Practice address
11568 225TH St
Cambria Heights, NY 11411-1235
Phone
(718) 341-0502
NPI assigned
May 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 639106-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403212 NY Primary

Addresses

Primary practice location

11568 225TH St
Cambria Heights, NY 11411-1235

Mailing address

11568 225TH St
Cambria Heights, NY 11411-1235
Phone (718) 341-0502

Other names 1

  • Miss Shirina Ally Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130001979 NY Practitioner - Nurse Practitioner 4981077468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
639106-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Care NP in Psychiatry P.C. Psychiatric/Mental Health CurrentSince Jan 1, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1114219011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11568 225TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111235",
            "telephone_number": "718-341-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11568 225TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111235",
            "telephone_number": "718-341-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLY",
        "first_name": "SHIRINA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "639106-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRINA",
            "last_name": "ALLY",
            "prefix": "MISS",
            "credential": "NP.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cambria Heights, NY

Sources for this page

Verify at the official NPI Registry.