Active NPI
Amanda Shinall, PA
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1376142737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 010483
- Practice address
- 28 Old Fulton St Apt 4B
Brooklyn, NY 11201-6909 - Phone
- (917) 538-4588
- NPI assigned
- Oct 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010483 | NY | Primary |
Addresses
Primary practice location
28 Old Fulton St Apt 4B
Brooklyn, NY 11201-6909
Mailing address
28 Old Fulton St Apt 4B
Brooklyn, NY 11201-6909
Phone (917) 538-4588
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Brooklyn | Direct |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010483 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602979200000",
"number": "1376142737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 OLD FULTON ST APT 4B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112016909",
"telephone_number": "917-538-4588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 OLD FULTON ST APT 4B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112016909",
"telephone_number": "917-538-4588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINALL",
"first_name": "AMANDA",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-18",
"last_updated": "2020-10-18",
"certification_date": "2020-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "010483",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Brooklyn",
"affiliation": "N",
"endpointDescription": "home",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "28 Old Fulton St Apt 4B",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112016909",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.