Individual provider Active NPI

Shanelle Veronica Stewart

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1235615048
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343909 Issued in NY
Practice address
1381 E 72ND St
Brooklyn, NY 11234-5803
Phone
(347) 854-3186
NPI assigned
Jul 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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 343909 NY Primary

Addresses

Primary practice location

1381 E 72ND St
Brooklyn, NY 11234-5803

Mailing address

1381 E 72ND St
Brooklyn, NY 11234-5803

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
I20210323001933 NY Practitioner - Nurse Practitioner 8224443205 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
RJ Medical & Urgent Care, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Fresh Meadows Physician Practice PLLC CurrentSince Nov 15, 2025 Accepting new patients
L'Refuah Medical & Rehabilitation Center, Inc. Student in an Organized Health Care Education/Training Program Past Accepting new patients
L'Refuah Medical & Rehabilitation Center, Inc. Past Accepting new patients

Locations

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

612 Allerton Ave
Bronx, NY 10467
Phone (718) 519-4125

108 Beverley Rd
#1
Brooklyn, NY 11218
Phone (347) 836-6923

464 Bay Ridge Ave
Ste A
Brooklyn, NY 11220
Phone (718) 680-6006

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1798/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: shanelle.stewart.1@24989.direct.athenahealth.com
  • Direct secure messaging: shanelle.stewart.p1@direct.ezramedical.nextgenshare.com

Organizations & group practices 4

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": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1235615048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 E 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 E 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345803",
            "telephone_number": "347-854-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SHANELLE",
        "middle_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.