Individual provider Active NPI

Pavel Shchegol

  • Psychiatric/Mental Health Registered Nurse
  • Rego Park, NY
National Provider Identifier
1457724809
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
571217 Issued in NY
Practice address
9520 63Rd Rd
Suite O
Rego Park, NY 11374-1160
Phone
(347) 813-4143
Fax
(347) 813-4146
NPI assigned
Nov 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 571217 NY Primary

Addresses

Primary practice location

9520 63Rd Rd
Suite O
Rego Park, NY 11374-1160

Mailing address

9520 63Rd Rd
Suite O
Rego Park, NY 11374-1160
Phone (347) 813-4143

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
571217NYMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1457724809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 63RD RD",
            "address_2": "SUITE O",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741160",
            "telephone_number": "347-813-4143",
            "fax_number": "347-813-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 63RD RD",
            "address_2": "SUITE O",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741160",
            "telephone_number": "347-813-4143",
            "fax_number": "347-813-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHCHEGOL",
        "first_name": "PAVEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "571217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.