Shalom Jaroslawicz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

347138 Issued in NY

Practice address

701 Mulberry PL
Valley Stream, NY 11581-3131

Phone

(646) 842-2367

NPI assigned

Jan 15, 2021

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime MD Center LLCGroup PAC ID 4981134863, 4 clinicians

Upstate Urgent Care PLLCGroup PAC ID 6507250644, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prime MD Center LLC

  • Clinic/Center
  • Woodmere, NY
  • NPI 1851104749
  Medicare reassignment Care Compare group NPD
• Upstate Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Woodmere, NY
  • NPI 1174194856
  Medicare reassignment Care Compare group NPD
• Park Avenue Pediatrics, P.C.

  • Pediatrics Physician
  • Spring Valley, NY
  • NPI 1699969543
  Medicare reassignment NPD

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1407445257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MULBERRY PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MULBERRY PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813131",
            "telephone_number": "646-842-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAROSLAWICZ",
        "first_name": "SHALOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Jaggon
• Rehana Jagnandan, PHARMD
• Jaime Gamatero PT P.C.
• Abimbola Jaiyesimi, NP
• Anil James, PHARM D
• Kimberly Dawn Jarrett-Waters, LMSW
• Andrea Jarrett
• Jason Cheung, OD, LLC
• Arshad Javaid
• Annette Javier

• Family Nurse Practitioner in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.