Individual provider Active NPI

Shanna Hinckson, FNP-BC

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1215540638
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346553 Issued in NY
Practice address
1050 Clove Road
Staten Island, NY 10301-3627
Phone
(718) 816-6440
Fax
(718) 420-2718
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 346553 NY Primary

Addresses

Primary practice location

1050 Clove Road
Staten Island, NY 10301-3627

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

455 Sutter Ave
Brooklyn, NY 11212-8111
Phone (718) 765-6550

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
I20210310002514 NY Practitioner - Nurse Practitioner 5092121343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

1050 Clove Rd
Staten Island, NY 10301-3627
Phone (718) 816-6440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346553NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jun 20, 2022 Accepting new patients
Advantagecare Physicians PC CurrentSince Jun 20, 2022 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

55 Water St
Fl 2
New York, NY 10041

1050 Clove Rd
Staten Island, NY 10301
Phone (718) 816-6440

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: shinckson44432@direct.acpny.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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1215540638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-816-6440",
            "fax_number": "718-420-2718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Sutter Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112128111",
            "country_code": "US",
            "telephone_number": "718-765-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINCKSON",
        "first_name": "SHANNA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.