Individual provider Active NPI

Tasnuva Nuhat Shafin, MD

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1497436745
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 270-1912
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P122969 NY
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Avenue
Internal Medicine Primary Care
Brooklyn, NY 11203-2012
Phone (860) 671-4273

Other practice location 1

428 Route 146
Altamont, NY 12009-4409
Phone (518) 861-5141

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
I20240316000177 NY Practitioner - Internal Medicine 2860838547 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P122969NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Medical Associate PLLC Internal Medicine CurrentSince Jan 22, 2024 Accepting new patients
Mill Basin Medical Health PC Internal Medicine CurrentSince Apr 2, 2024 Accepting new patients

Locations

428 State Route 146
Altamont, NY 12009
Phone (518) 861-5141

1583 E 66th St
#1
Brooklyn, NY 11234
Phone (917) 318-4724

48 Frost Ln
Unit A
Lawrence, NY 11559
Phone (516) 587-9960

300 Community Dr
Plandome, NY 11030

Organizations & group practices 2

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1497436745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVENUE",
            "address_2": "INTERNAL MEDICINE PRIMARY CARE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "860-671-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "428 Route 146",
            "address_purpose": "LOCATION",
            "city": "Altamont",
            "state": "NY",
            "postal_code": "120094409",
            "country_code": "US",
            "telephone_number": "518-861-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFIN",
        "first_name": "TASNUVA NUHAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P122969",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.