Individual provider Active NPI

Shahedara Shilu

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1437867785
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350601 Issued in NY
Practice address
3008 Lasalle Ave
Bronx, NY 10461-6022
Phone
(703) 608-0144
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350601 NY Primary

Addresses

Primary practice location

3008 Lasalle Ave
Bronx, NY 10461-6022

Mailing address

3008 Lasalle Ave
Bronx, NY 10461-6022
Phone (703) 608-0144

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230202000087 NY Practitioner - Nurse Practitioner 9638541543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

545 E 142ND St
Bronx, NY 10454-2110
Phone (718) 579-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
350601NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Apr 21, 2024 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Apr 21, 2024 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

545 E 142nd St
Bronx, NY 10454
Phone (718) 579-1719

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

Networks

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

Interoperability endpoints

  • Direct secure messaging: sshilu3588050@nychhc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1437867785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 LASALLE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616022",
            "telephone_number": "703-608-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 LASALLE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616022",
            "telephone_number": "703-608-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILU",
        "first_name": "SHAHEDARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.