Sandra Shivamber, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F335980-1 Issued in NY

Practice address

1991 Marcus Ave
Suite M107
Lake Success, NY 11042

Phone

(516) 222-2288

Fax

(516) 745-0976

NPI assigned

Sep 24, 2010

Last updated

Sep 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• North Shore Long Island Jewish Healthcare

  dba Northwell Healthcare Inc

  • Cardiovascular Disease Physician
  • Westbury, NY
  • NPI 1215019500
  Medicare reassignment NPD
• North Shore Long Island Jewish Health Care Inc

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912338385
  NPD
• Frederic J. Vagnini, MD, Facs

  • Cardiovascular Disease Physician
  • New Hyde Park, NY
  • NPI 1801843370
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1265741292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "M107",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-222-2288",
            "fax_number": "516-745-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "SUITE M107",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-222-2288",
            "fax_number": "516-745-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAMBER",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335980",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335980-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Schron, MD
• Michael Howard Schwartz, D.D.S.
• Stephen Senreich, MD
• Trusha Narendra Shah, M.D.
• Roopalatha P Shenoy, OTRL
• Lawrence Shulman, MD
• Krista Sickler
• Steven Scott Siegel, DPM
• Brian Richard Simon
• Puneet Singh, D.O.

• Family Nurse Practitioner in Lake Success, NY
• Providers in Lake Success, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.