Ivy L Shen, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

133716 Issued in NY

Practice address

4211 Kissena Blvd
Flushing, NY 11355

Phone

(718) 353-4484

Fax

(718) 353-5075

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• St Vincents Hospital and Medical Center

  • Specialist
  • New York, NY
  • NPI 1285746354
  NPD (past)
• The New York Eye & Ear Infirmary Ophthalmology Associates, P.C.

  • Specialist
  • New York, NY
  • NPI 1811931041
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629134424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 KISSENA BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "212-941-8833",
            "fax_number": "212-941-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 KISSENA BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-353-4484",
            "fax_number": "718-353-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "IVY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "133716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00533326",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shen Smiles, LLC
• Shen-Han Lin Medical PC
• Angela Yue Shen
• Chen Shen
• Christine Jianhua Shen, M.D.
• Jieying Shen, M.D.
• Katherina Shen, OTR
• Min You Shen, LAC LICENSED ACUPUNC
• Pei Hung Shen
• Stephanie Shen, MD

• Ophthalmology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.