Individual provider Active NPI

Yekaterina Shubova, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1316289861
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014371-1 Issued in NY
Practice address
139 Hull Ave
Staten Island, NY 10306-3501
Phone
(917) 435-7182
NPI assigned
Mar 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 014371-1 NY Primary

Addresses

Primary practice location

139 Hull Ave
Staten Island, NY 10306-3501

Mailing address

139 Hull Ave
Staten Island, NY 10306-3501
Phone (917) 435-7182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014371-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yekaterina Shubova PT PastSince Nov 10, 2019 Accepting new patients
Lic Strong Physical Therapy PLLC Physical Therapist Past Accepting new patients

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1316289861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HULL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063501",
            "telephone_number": "917-435-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HULL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063501",
            "telephone_number": "917-435-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBOVA",
        "first_name": "YEKATERINA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014371-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.