Shoshana Polevoy, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95001296 Issued in CA

Practice address

11411 Brookshire Ave
Suite 508
Downey, CA 90241-5026

Phone

(562) 923-0706

NPI assigned

Sep 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shoshana Agatstein Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shoshana.polevoy@119401271263236.direct.elationemr.com

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.

• Genesis Healthcare Partners, PC

  • Non-Pharmacy Dispensing Site
  • Downey, CA
  • NPI 1134939713
  NPD

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1326441817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845996",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845996",
            "telephone_number": "858-888-7700",
            "fax_number": "858-221-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 BROOKSHIRE AVE",
            "address_2": "SUITE 508",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415026",
            "telephone_number": "562-923-0706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Katella Ave Ste 223",
            "address_purpose": "LOCATION",
            "city": "Los Alamitos",
            "state": "CA",
            "postal_code": "907206904",
            "country_code": "US",
            "telephone_number": "562-449-4183",
            "fax_number": "562-861-2133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15111 Whittier Blvd Ste 390",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906033301",
            "country_code": "US",
            "telephone_number": "562-320-8281",
            "fax_number": "562-861-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLEVOY",
        "first_name": "SHOSHANA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHOSHANA",
            "last_name": "AGATSTEIN",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Downey, CA
• Providers in Downey, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.