Individual provider Active NPI

Shlomo Shinnar, MD,PH.D

  • Neurology with Special Qualifications in Child Neurology Physician
  • Bronx, NY
National Provider Identifier
1205911526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
153943 Issued in NY
Practice address
MMC - Epilepsy Center
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 920-4378
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 153943 NY Primary

Addresses

Primary practice location

MMC - Epilepsy Center
111 East 210TH Street
Bronx, NY 10467

Mailing address

140 Taymil Rd
New Rochelle, NY 10804-2211
Phone (718) 920-4378

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080117000652 NY Practitioner - Neurology 0042391815 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153943NYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Feb 27, 2018 Accepting new patients
Montefiore Medical Center Neurology With Special Qualifications in Child Neurology CurrentSince Feb 27, 2018 Accepting new patients

Locations

3351 Steuben Ave
Bronx, NY 10467
Phone (646) 256-8455

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: sshinnar845188@nychhc.direct-ci.com

Organizations & group practices 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205911526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 TAYMIL RD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042211",
            "telephone_number": "718-920-4378",
            "fax_number": "718-652-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - EPILEPSY CENTER",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNAR",
        "first_name": "SHLOMO",
        "credential": "MD,PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "153943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.