Active NPI
Sherissa Charles, M.D.
- Family Medicine Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 292111
- Practice address
- 3080 Atlantic Ave
Brooklyn, NY 11208-1268 - Phone
- (718) 647-0240
- NPI assigned
- May 27, 2015
- Last updated
- Oct 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 292111 | NY | Primary |
Addresses
Primary practice location
3080 Atlantic Ave
Brooklyn, NY 11208-1268
Mailing address
13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05269856 | Medicaid | NY |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-3428
2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone (631) 376-3131
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Medical Center | Current | Accepting new patients | |
| CHS Physician Partners, P.C | Current | Accepting new patients | |
| CHS Physician Partners, PC | Current | Accepting new patients | |
| Jamaica Hospital | Current | Accepting new patients | |
| Mercy Medical Center | Current | Accepting new patients | |
| Jamaica Hospital | Current | Accepting new patients | |
| CHS Physician Partners, PC | Current | Accepting new patients |
Locations
3080 Atlantic Ave
Brooklyn, NY 11208
Phone (718) 647-0240
18803 Jamaica Ave
Jamaica, NY 11423
Phone (718) 740-2060
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012
2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777
2000 N Village Ave
Ste 208
Rockville Ctr, NY 11570
Phone (516) 766-0500
100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- scharles158969@direct-chsli.net
- scharles42253@direct.medisys.org
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Cardiac Interventional Group
- Interventional Cardiology Physician
- Fresh Meadows, NY
- NPI 1407089345
-
- Internal Medicine Physician
- Rockville Centre, NY
- NPI 1619245610
-
dba Jamaica Hospital Emergency Department - Radiology
- Emergency Medical Services (Emergency Medicine) Physician
- Jamaica, NY
- NPI 1477505220
-
- Cardiovascular Disease Physician
- Roslyn, NY
- NPI 1164585725
-
dba Cardiac Interventional Group
- Interventional Cardiology Physician
- Roslyn, NY
- NPI 1881825701
-
- Skilled Nursing Facility
- Jamaica, NY
- NPI 1750516795
-
- Internal Medicine Physician
- Rockville Centre, NY
- NPI 1104097294
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Rockville Centre, NY
- NPI 1427017854
-
- Rehabilitation Hospital Unit
- Rockville Centre, NY
- NPI 1598724924
-
- General Acute Care Hospital
- Rockville Centre, NY
- NPI 1659330173
-
dba Catholic Health Home Care
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1235518978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13303 JAMAICA AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114182618",
"telephone_number": "718-206-6942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3080 ATLANTIC AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112081268",
"telephone_number": "718-647-0240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "SHERISSA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-27",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "292111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05269856",
"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 Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.