NPIMap

Individual provider Active NPI

Shani Julie Fruchter, D.O.

  • Surgery Physician
  • New York, NY
National Provider Identifier
1235491374
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
296071 Issued in NY
Practice address
530 1St Ave Ste 6B
New York, NY 10016-6402
Phone
(646) 501-0584
Fax
(646) 501-9995
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 296071 NY Primary

Addresses

Primary practice location

530 1St Ave Ste 6B
New York, NY 10016-6402

Mailing address

530 1St Ave Ste 6B
New York, NY 10016-6402
Phone (646) 501-0584

Other practice location 1

7600 River Rd
North Bergen, NJ 07047-6217
Phone (718) 490-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211002635 NY Practitioner - General Surgery 6002168200 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

6511 Spring Brook Ave
Suite 1004
Rhinebeck, NY 12572-3709
Phone (845) 227-6947

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
296071NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 18, 2019 Accepting new patients
Acute Care Medical Services PLLC Surgery CurrentSince Jul 1, 2022 Accepting new patients
Optum Medical Care, P.C. Surgery CurrentSince Apr 15, 2024 Accepting new patients
Nuvance Health Medical Practice PC CurrentSince Mar 28, 2022 Accepting new patients
Long Island Surgical PLLC Surgery CurrentSince Nov 5, 2022 Accepting new patients
New York University Surgery CurrentSince Dec 18, 2019 Accepting new patients
Optum Medical Care, P.C. CurrentSince Apr 15, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Apr 13, 2024 Accepting new patients
Montefiore Medical Center Surgery CurrentSince Apr 13, 2024 Accepting new patients
South Island Orthopedics, P.C. Past Accepting new patients
Mount Kisco Medical Group Surgery Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

111 E 210th St
Bronx, NY 10467

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

530 1st Ave
Ste 6B
New York, NY 10016
Phone (212) 263-7301

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

6511 Spring Brook Ave
Ste 1004
Rhinebeck, NY 12572
Phone (845) 871-4275

2000 N Village Ave
Ste 211
Rockville Ctr, NY 11570
Phone (516) 764-1303

575 Underhill Blvd
Ste 130
Syosset, NY 11791
Phone (516) 294-9540

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: sfruchter121808@direct.optum.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1235491374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST AVE STE 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "646-501-0584",
            "fax_number": "646-501-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE STE 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "646-501-0584",
            "fax_number": "646-501-9995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 River Rd",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070476217",
            "country_code": "US",
            "telephone_number": "718-490-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUCHTER",
        "first_name": "SHANI",
        "middle_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "296071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.