Individual provider Active NPI

Shelly Hodaya Twito, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1619624079
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347640 Issued in NY
Practice address
560 Halsey St
Brooklyn, NY 11233-4376
Phone
(718) 602-3788
NPI assigned
Mar 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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 347640 NY Primary

Addresses

Primary practice location

560 Halsey St
Brooklyn, NY 11233-4376

Mailing address

1103 Sheepshead Bay Rd Apt A2
Brooklyn, NY 11229-4258
Phone (917) 945-1205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240715003372 LA Practitioner - Nurse Practitioner 0042663353 Reassigns benefits to 1 organization
I20241204002547 NY Practitioner - Nurse Practitioner 0042663353 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
347640NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Urgent & Walk in Medical Care PLLC CurrentSince Sep 27, 2024 Accepting new patients
Hicksville Family Medical Care, PLLC CurrentSince Sep 27, 2024 Accepting new patients
KCC Infusion, LLC CurrentSince May 1, 2024 Accepting new patients
Usukumah E. Usukumah Medical, PLLC CurrentSince Mar 13, 2022 Accepting new patients
JPR Urgent Medical Care Past Accepting new patients

Locations

8625 Line Ave
Ste B
Shreveport, LA 71106
Phone (318) 673-8360

412 S Broadway
Hicksville, NY 11801
Phone (516) 938-1550

232 W Old Country Rd
Hicksville, NY 11801
Phone (347) 808-8830

Organizations & group practices 5

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": "1646524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1619624079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 SHEEPSHEAD BAY RD APT A2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294258",
            "telephone_number": "917-945-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 HALSEY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112334376",
            "telephone_number": "718-602-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWITO",
        "first_name": "SHELLY",
        "middle_name": "HODAYA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-06",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.