Individual provider Active NPI

Shawn Andrea Tapper, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1558679563
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336191-1 Issued in NY
Practice address
1114 Liberty Ave
Brooklyn, NY 11208-2922
Phone
(718) 765-6058
Fax
(347) 808-4895
NPI assigned
Sep 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336191-1 NY Primary

Addresses

Primary practice location

1114 Liberty Ave
Brooklyn, NY 11208-2922

Mailing address

PO Box 746085
Atlanta, GA 30374-6085
Phone (312) 733-9730

Other practice location 1

232 Merrick Rd
Lynbrook, NY 11563-2623
Phone (516) 594-5961

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222000261 NY Practitioner - Nurse Practitioner 5597902064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

50 Sheffield Ave
Brooklyn, NY 11207-2420
Phone (718) 345-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336191-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Director Services PC CurrentSince Oct 25, 2023 Accepting new patients

Locations

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1558679563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746085",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082922",
            "telephone_number": "718-765-6058",
            "fax_number": "347-808-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115632623",
            "country_code": "US",
            "telephone_number": "516-594-5961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAPPER",
        "first_name": "SHAWN",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336191-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.