Shelby Tharakan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F344111-1 Issued in NY

Practice address

11912 94TH Ave FL 1
South Richmond Hill, NY 11419-1332

Phone

(718) 297-0440

NPI assigned

May 16, 2019

Last updated

Feb 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New York Community Hospital of Brooklyn Inc

  dba New York Community Hospital

  • Psychiatric Hospital Unit
  • Brooklyn, NY
  • NPI 1508377334
  Medicare reassignment NPD
• New York Community Hospital of Brooklyn Inc

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1215030697
  NPD
• New York Community Hospital of Brooklyn, Inc.

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1205840055
  NPD (past)

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1194381020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 THE DELL",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071014",
            "telephone_number": "516-270-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 94TH AVE FL 1",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191332",
            "telephone_number": "718-297-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARAKAN",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344111",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344111-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T&D Medical Supplies Inc
• Rana Tahir
• Jocelyn Tan, O.D.
• Rita Mae Tan, OTRL
• Michael Tanlioco, PHYSICAL THERAPIST
• The Tarbiyah Inc
• Therapy Care Pta P.C.
• Jeremiah Thyagaraj, MD
• TM Social Adult Daycare Inc.
• Top Notch RX Inc

• Family Nurse Practitioner in South Richmond Hill, NY
• Providers in South Richmond Hill, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.