Individual provider Active NPI

Rahul Sharma, LPN

  • Licensed Practical Nurse
  • Long Island City, NY
National Provider Identifier
1548613482
Registry record updated Jan 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
297482 Issued in NY
Practice address
3418 Northern Blvd
Long Island City, NY 11101-2807
Phone
(929) 268-6969
Fax
(718) 425-0880
NPI assigned
Jul 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 219510 TX
Licensed Practical Nurse 164W00000X 297482 NY Primary

Addresses

Primary practice location

3418 Northern Blvd
Long Island City, NY 11101-2807

Mailing address

3418 Northern Blvd
Long Island City, NY 11101-2807
Phone (929) 268-6969

Other names 1

  • Mr. Rahul Sharma Professional name

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
297482NYMDLicensed Practical Nurse
219510TXMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
USA Medlog Inc. Current Accepting new patients

Locations

3418 Northern Blvd
Long Island City, NY 11101
Phone (212) 529-9280

Organizations & group practices 1

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": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1548613482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012807",
            "telephone_number": "929-268-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012807",
            "telephone_number": "929-268-6969",
            "fax_number": "718-425-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "RAHUL",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "219510",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "297482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAHUL",
            "last_name": "SHARMA",
            "prefix": "MR.",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2024; 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.