Individual provider Active NPI

Shirin Braun, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1194407775
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030563 Issued in NY
Practice address
535 W 110TH St
Unit 1E
New York, NY 10025
Phone
(212) 280-4740
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 030563 NY Primary

Addresses

Primary practice location

535 W 110TH St
Unit 1E
New York, NY 10025

Mailing address

40 W 135TH St Apt 7a
New York, NY 10037-2508
Phone (610) 400-9663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240618000550 NY Practitioner - Physician Assistant 2860935962 Reassigns benefits to 2 organizations
I20250911003192 NJ Practitioner - Physician Assistant 2860935962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Medicine PLLCGroup PAC ID 1456879451, 23 clinicians

Practice addresses (Care Compare)

300 W 108TH St
New York, NY 10025-2788
Phone (212) 280-4740

535 W 110TH St
Apt 1E
New York, NY 10025-2021
Phone (212) 280-4740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
030563NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Chiropractic Enterprise PLLC Past Accepting new patients
Practice Associates Medical Group Past Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1194407775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 135TH ST APT 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100372508",
            "telephone_number": "610-400-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST",
            "address_2": "UNIT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-280-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "SHIRIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2024-02-14",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.