Individual provider Active NPI

Sheelu Noble Varghese, N.P

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1205202934
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339105-1 Issued in NY
Practice address
39 Norwich St
Staten Island, NY 10314-6305
Phone
(718) 702-6218
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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 558512-1 NY
Family Nurse Practitioner 363LF0000X F339105-1 NY Primary

Addresses

Primary practice location

39 Norwich St
Staten Island, NY 10314-6305

Mailing address

39 Norwich St
Staten Island, NY 10314-6305
Phone (718) 702-6218

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
I20201011000001 NY Practitioner - Nurse Practitioner 4082034178 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
558512-1NYMDRegistered Nurse
F339105-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients

Locations

50 Water St
Fl 3
New York, NY 10004

Interoperability endpoints

  • Direct secure messaging: svarghese2018849@nychhc.direct-ci.com

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1205202934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 NORWICH ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146305",
            "telephone_number": "718-702-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 NORWICH ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146305",
            "telephone_number": "718-702-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "SHEELU",
        "middle_name": "NOBLE",
        "name_prefix": "Mrs.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "558512-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339105-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.