Individual provider Active NPI

Shiny Sony Varghese, CPNP

  • Pediatric Nurse Practitioner
  • Albertson, NY
National Provider Identifier
1275837445
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382182 Issued in NY
Practice address
10 Valentine Dr
Albertson, NY 11507-2222
Phone
(516) 353-1410
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F382182 NY Primary
Pediatric Nurse Practitioner 363LP0200X 9228048 FL

Addresses

Primary practice location

10 Valentine Dr
Albertson, NY 11507-2222

Mailing address

10 Valentine Dr
Albertson, NY 11507-2222
Phone (516) 343-1410

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
I20151118002876 NY Practitioner - Nurse Practitioner 4981904240 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9228048FLMDPediatric Nurse Practitioner
F382182NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 16, 2015 Accepting new patients
Jamaica Hospital CurrentSince Oct 1, 2015 Accepting new patients
Jamaica Hospital CurrentSince Oct 1, 2015 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

300 Community Dr
Plandome, NY 11030

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: svarghese44106@direct.medisys.org

Organizations & group practices 3

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1275837445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 VALENTINE DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115072222",
            "telephone_number": "516-343-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 VALENTINE DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115072222",
            "telephone_number": "516-353-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "SHINY",
        "middle_name": "SONY",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382182",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9228048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albertson, NY

Sources for this page

Verify at the official NPI Registry.