Individual provider Active NPI

Shelena Ali-Bynom, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1306378583
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
311539-01 Issued in NY
Practice address
121 Dekalb Ave
House Staff Administration
Brooklyn, NY 11201-5425
Phone
(718) 250-8000
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME167190 FL
Obstetrics & Gynecology Physician 207V00000X 311539-01 NY Primary

Addresses

Primary practice location

121 Dekalb Ave
House Staff Administration
Brooklyn, NY 11201-5425

Mailing address

121 Dekalb Ave
Department of Obstetrics and Gunecology
Brooklyn, NY 11201-5425

Other practice location 1

1525 Lakeland Hills Blvd
Lakeland, FL 33805-3203
Phone (863) 284-6860

Other practice location 2

430 E Central Ave
Winter Haven, FL 33880-3050
Phone (863) 284-5000

Other practice location 3

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 846-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409003501 FL Practitioner - Obstetrics/Gynecology 9032456207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
311539-01NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Apr 3, 2024 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3015 Lakeland Highlands Rd
Lakeland, FL 33803
Phone (863) 284-6860

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 284-6860

1637 Shepherd Rd
Lakeland, FL 33811
Phone (863) 284-1626

430 E Central Ave
Winter Haven, FL 33880
Phone (863) 284-5061

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: salibynom53464@lrhs.direct-ci.com

Organizations & group practices 2

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1306378583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "address_2": "DEPARTMENT OF OBSTETRICS AND GUNECOLOGY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "address_2": "HOUSE STAFF ADMINISTRATION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053203",
            "country_code": "US",
            "telephone_number": "863-284-6860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338803050",
            "country_code": "US",
            "telephone_number": "863-284-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-846-6860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI-BYNOM",
        "first_name": "SHELENA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME167190",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "311539-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.