Individual provider Active NPI

Shahnoz Rustamova

  • Obstetrics Physician
  • New York, NY
National Provider Identifier
1629112149
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
245082 Issued in NY
Practice address
200 W 57TH St
Ste 1005
New York, NY 10019-3237
Phone
(212) 974-0490
NPI assigned
Feb 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 245082 NY Primary

Addresses

Primary practice location

200 W 57TH St
Ste 1005
New York, NY 10019-3237

Mailing address

134 West, 58TH Street,
Suite102
New York, NY 10019
Phone (212) 974-0490

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
I20080828000546 NY Practitioner - Obstetrics/Gynecology 4587730486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

134 W 58TH St
Suite 102
New York, NY 10019-2153
Phone (212) 974-0490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245082NYMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Power of Health and Wellness LLC Current Accepting new patients
Central Park Medical Practice Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
Ruth Steinberg, MD, LLC PastSince Aug 25, 2008 Accepting new patients

Locations

1025 Military Trl
Ste 113
Jupiter, FL 33458
Phone (561) 354-1002

Networks

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

Interoperability endpoints

  • Direct secure messaging: srustamova14549@nychhc.direct-ci.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1629112149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 WEST, 58TH STREET,",
            "address_2": "SUITE102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-974-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "STE 1005",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193237",
            "telephone_number": "212-974-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTAMOVA",
        "first_name": "SHAHNOZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "245082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.