Organization Active NPI

Shimons Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1629147012
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
024761 Issued in NY
Legal business name
SHIMONS PHARMACY INC
Practice address
115 Lee Ave
Brooklyn, NY 11211-7904
Phone
(718) 384-0234
Fax
(718) 384-3910
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Mr. Ersel KohantebNPI 1508148446
Title
President
Phone
(718) 384-0234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 024761 NY Primary

Addresses

Primary practice location

115 Lee Ave
Brooklyn, NY 11211-7904

Mailing address

115 Lee Ave
Brooklyn, NY 11211-7904
Phone (718) 384-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220912000721 NY Part B Supplier - Pharmacy 7911242581 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1629147012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117904",
            "telephone_number": "718-384-0234",
            "fax_number": "718-384-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117904",
            "telephone_number": "718-384-0234",
            "fax_number": "718-384-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIMONS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "KOHANTEB",
        "authorized_official_first_name": "ERSEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-384-0234",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "024761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.