Individual provider Active NPI

Eslam Shoaab

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1205294683
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
3203054 Issued in NY
Practice address
2750 W 33Rd St Apt 1449
Brooklyn, NY 11224-5006
Phone
(718) 600-7071
NPI assigned
Feb 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 3203054 NY Primary

Addresses

Primary practice location

2750 W 33Rd St Apt 1449
Brooklyn, NY 11224-5006

Mailing address

2750 W 33Rd St Apt 1449
Brooklyn, NY 11224-5006

Other identifiers 1

IdentifierTypeStateIssuer
323054MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3203054NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1205294683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W 33RD ST APT 1449",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112245006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W 33RD ST APT 1449",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112245006",
            "telephone_number": "718-600-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOAAB",
        "first_name": "ESLAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "3203054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323054",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.