Shobin Oommen Physician, PC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

246228 Issued in NY

Legal business name

SHOBIN OOMMEN PHYSICIAN, PC

Practice address

35 Pilgrim St
New Hyde Park, NY 11040-3140

Phone

(917) 797-4421

NPI assigned

Jun 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Shobin Oommen, MDNPI 1205035383

Title

Medical Doctor

Phone

(917) 797-4421

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shobin Oommen, M.D.

  • Psychiatry Physician
  • Stroudsburg, PA
  • NPI 1205035383

  NY

  Medicare reassignment NPD Authorized official
• Michael John Nuccitelli, PSY.D.

  • Clinical Psychologist
  • Brewster, NY
  • NPI 1740303940
  Medicare reassignment NPD
• Yitzchok D. Wagshul, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1841769965
  Medicare reassignment NPD

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1275853129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 STEWART AVE",
            "address_2": "SUITE 16",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304803",
            "telephone_number": "516-745-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PILGRIM ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403140",
            "telephone_number": "917-797-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOBIN OOMMEN PHYSICIAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "OOMMEN",
        "authorized_official_first_name": "SHOBIN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "917-797-4421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "246228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Shikowitz, MD
• Jason Jeong Soo Shin, PT, DPT
• Young H Shin, MD
• Emily Mei Shipley, PA-C
• Humaira Shoaib, M.D
• Jasmin Shon
• Linda Shore-Lesserson, M.D.
• Barbara Shorter
• Shraddha Adhvaryu, Dentist, PC
• Michael Stuart Shreck, D.M.D.

• Behavior Analyst in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.