Tamara Shimunov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

018345 Issued in NY

Practice address

14130 Pershing Cres
Jamaica, NY 11435-1952

Phone

(929) 365-1271

Fax

(929) 365-1271

NPI assigned

Jul 18, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

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

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.

• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  Medicare reassignment
• Interfaith Emergency Medicine, P.C.

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1457643785
  Medicare reassignment
• Metropolitan Medical Practice Plan PC

  • General Practice Physician
  • New York, NY
  • NPI 1306138383
  Medicare reassignment

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1356639835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14130 PERSHING CRES",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 PERSHING CRES",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351952",
            "telephone_number": "929-365-1271",
            "fax_number": "929-365-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMUNOV",
        "first_name": "TAMARA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun Jung Shim, MS, RD, CDN
• Justin Shim, RPH
• Julia Shimon, OTR/L
• Anzhelika R Shimunov, S.I.
• Roza Shimunov
• Kihun Shin
• Sukhdip Singh Shina, M.D.
• Benasha D Shine, LMSW
• Jeffrey Shing, PHARM. D.
• Shining Stars Adult Daycare Corp

• Physician Assistant in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.