Individual provider Active NPI

Shinawe Jimenez, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1487870952
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
241670 Issued in NY
Practice address
760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics
Brooklyn, NY 11206
Phone
(718) 963-8000
Fax
(718) 630-3122
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 241670 NY Primary

Addresses

Primary practice location

760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics
Brooklyn, NY 11206

Mailing address

760 Broadway, Woodhull Medical & Mental Health Center
Department of Pediatrics Room 2B-321
Brooklyn, NY 11206
Phone (718) 963-8000

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
I20110311000486 NY Practitioner - Pediatric Medicine 4587846548 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241670NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Medical Services of New York PC CurrentSince Dec 4, 2015 Accepting new patients
New York University Pediatrics CurrentSince Sep 1, 2016 Accepting new patients
North Shore-Lij Medical PC CurrentSince Feb 14, 2018 Accepting new patients
Nes Medical Services of New York PC CurrentSince Dec 4, 2015 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 14, 2018 Accepting new patients
New York University CurrentSince Sep 1, 2016 Accepting new patients

Locations

760 Broadway
#O
Brooklyn, NY 11206

760 Broadway
Brooklyn, NY 11206
Phone (718) 963-5807

760 Broadway
Rm 2B321
Brooklyn, NY 11206
Phone (718) 963-8214

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

100 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-2900

300 Community Dr
Plandome, NY 11030

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: sjimenez562978@nychhc.direct-ci.com

Organizations & group practices 6

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1487870952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS ROOM 2B-321",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SHINAWE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "241670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.