Individual provider Active NPI

Samah Mohamed Mahmoud Shahen

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1386951838
Registry record updated Sep 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028707 Issued in NY
Practice address
121 70TH St
2ND Floor
Brooklyn, NY 11209-1129
Phone
(917) 302-0047
NPI assigned
Sep 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2010

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 028707 NY Primary

Addresses

Primary practice location

121 70TH St
2ND Floor
Brooklyn, NY 11209-1129

Mailing address

121 70TH St
2ND Floor
Brooklyn, NY 11209-1129
Phone (917) 302-0047

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
028707NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283558400000",
    "number": "1386951838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 70TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091129",
            "telephone_number": "917-302-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 70TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091129",
            "telephone_number": "917-302-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEN",
        "first_name": "SAMAH",
        "middle_name": "MOHAMED MAHMOUD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-04",
        "last_updated": "2010-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 4, 2010; 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.