Active NPI
Elina Shalomova, PA
- Physician Assistant
- Rego Park, NY
National Provider Identifier
1487755336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 011421
- Practice address
- 9810 64TH Ave Apt 3H
Rego Park, NY 11374-2502 - Phone
- (917) 517-9743
- Fax
- (917) 517-9743
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011421 | NY | Primary |
Addresses
Primary practice location
9810 64TH Ave Apt 3H
Rego Park, NY 11374-2502
Mailing address
9810 64TH Ave Apt 3H
Rego Park, NY 11374-2502
Phone (347) 306-5031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00246075 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- eshalomova@yourcarecommunity.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1487755336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9810 64TH AVE APT 3H",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742502",
"telephone_number": "347-306-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9810 64TH AVE APT 3H",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742502",
"telephone_number": "917-517-9743",
"fax_number": "917-517-9743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHALOMOVA",
"first_name": "ELINA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00246075",
"state": "NY"
}
],
"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 Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.