Shine George

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F404525-01 Issued in NY

Practice address

Brunswick Hospital
81 Lauden Ave
Amityville, NY 11701

Phone

(631) 789-7708

NPI assigned

Dec 9, 2022

Last updated

Dec 9, 2022By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nassau Suffolk Psychiatry PC

  • Psychiatry Physician
  • East Meadow, NY
  • NPI 1750620035
  Medicare reassignment NPD

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1629789748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562",
            "address_2": "7TH STREET",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "11554",
            "telephone_number": "516-467-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRUNSWICK HOSPITAL",
            "address_2": "81 LAUDEN AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-789-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "SHINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404525-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge L. Gardyn, M.D.
• Tricia Marie Gates
• Denae Gatling
• Edison Genaro Gavilanes, MD
• Geetha Balamurugan,D.D.S.,P.C.
• Waheed U Ghauri, RPH
• Skyler Gherardi, LMSW
• Ibrahim Mostafa Ghobashy, DENTAL DEGREE DDS
• Piya Ghoshal, M.D.
• Nicole Marie Gianotti, DPT

• Psychiatric/Mental Health Nurse Practitioner in Amityville, NY
• Providers in Amityville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.