Individual provider Active NPI

Mark Sheynshteyn, D.O

  • Endocrinology, Diabetes & Metabolism Physician
  • Staten Island, NY
National Provider Identifier
1447517883
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
279051 Issued in NY
Practice address
1366 Victory Blvd Ste a
Staten Island, NY 10301-3948
Phone
(718) 727-1366
Fax
(718) 727-5041
NPI assigned
Apr 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 77673 GA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 279051 NY Primary

Addresses

Primary practice location

1366 Victory Blvd Ste a
Staten Island, NY 10301-3948

Mailing address

963 Rathbun Ave
Staten Island, NY 10309-2224
Phone (347) 615-6331

Other practice location 1

2069 85th St Apt 5A
Brooklyn, NY 11214-3230
Phone (347) 615-6331

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151028001057 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 7618286907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1366 Victory Blvd
Suite a
Staten Island, NY 10301-3948
Phone (718) 816-4949

Hospital & facility affiliations

  • Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028
  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77673GAMDEndocrinology, Diabetes & Metabolism Physician
279051NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Sep 3, 2019 Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 3, 2019 Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1366 Victory Blvd
Staten Island, NY 10301
Phone (718) 273-3400

4360 Hylan Blvd
Staten Island, NY 10312
Phone (718) 818-4360

1366 Victory Blvd
Ste A
Staten Island, NY 10301
Phone (718) 727-1366

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

800 Castleton Ave
Staten Island, NY 10310
Phone (718) 354-3344

Networks

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

Interoperability endpoints

  • Direct secure messaging: mark.sheynshteyn.1@19656.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1447517883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 RATHBUN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092224",
            "telephone_number": "347-615-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD STE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013948",
            "telephone_number": "718-727-1366",
            "fax_number": "718-727-5041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2069 85th St Apt 5A",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143230",
            "country_code": "US",
            "telephone_number": "347-615-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEYNSHTEYN",
        "first_name": "MARK",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "77673",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "279051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.