Individual provider Active NPI

Yevgeniy Shustorovich, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1114925765
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME165853 Issued in FL
Practice address
1 Gustave L Levy PL
Anesthesiology - Box 1010
New York, NY 10029-6504
Phone
(800) 627-4470
Fax
(412) 937-5710
NPI assigned
Jul 8, 2005
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME165853 FL Primary
Anesthesiology Physician 207L00000X 213579-1 NY

Addresses

Primary practice location

1 Gustave L Levy PL
Anesthesiology - Box 1010
New York, NY 10029-6504

Mailing address

PO Box 5024
New York, NY 10087-5024
Phone (800) 627-4470

Other identifiers 1

IdentifierTypeStateIssuer
01991079MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241213001855 FL Practitioner - Anesthesiology 8224045471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone (561) 498-4440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213579-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services LLC CurrentSince Jan 8, 2026 Accepting new patients
American Anesthesiology of Florida, Inc Anesthesiology CurrentSince Dec 1, 2024 Accepting new patients
Tenet Florida Physician Services, LLC CurrentSince Jan 8, 2026 Accepting new patients
American Anesthesiology of Florida, Inc Anesthesiology CurrentSince Dec 1, 2024 Accepting new patients
Seaview Medical Group, PC Past Accepting new patients
Troy Anesthesiologists, PC Anesthesiology Past Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology Past Accepting new patients

Locations

21644 State Road 7
Boca Raton, FL 33428
Phone (561) 488-8210

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

5440 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-1000

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1114925765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5024",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875024",
            "telephone_number": "800-627-4470",
            "fax_number": "412-937-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "ANESTHESIOLOGY - BOX 1010",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "800-627-4470",
            "fax_number": "412-937-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTOROVICH",
        "first_name": "YEVGENIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME165853",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "213579-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01991079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.