Organization Active NPI

Shen Medical Ny PLLC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1255204350
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SHEN MEDICAL NY PLLC
Practice address
818 55TH St FL 3
Brooklyn, NY 11220-3213
Phone
(646) 517-5522
NPI assigned
Sep 25, 2025
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Shen Fengyi
Title
Owner/Authorized Official
Phone
(646) 517-5522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

818 55TH St FL 3
Brooklyn, NY 11220-3213

Mailing address

818 55TH St FL 3
Brooklyn, NY 11220-3213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251224000123 NY Part B Supplier - Clinic/Group Practice 7618462995 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1255204350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 55TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 55TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203213",
            "telephone_number": "646-517-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEN MEDICAL NY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "FENGYI",
        "authorized_official_first_name": "SHEN",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "646-517-5522"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.