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Individual provider Active NPI

Shawanda Monique Patterson, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1639587082
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ1254900 Issued in NJ
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(646) 426-3876
Fax
(212) 305-2792
NPI assigned
Jul 29, 2014
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 559461 NY
Adult Health Nurse Practitioner 363LA2200X 26NJ1254900 NJ Primary
Adult Health Nurse Practitioner 363LA2200X 307009 NY
Gerontology Nurse Practitioner 363LG0600X 26NJ01254900 NJ

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

710 W 168TH St
New York, NY 10032-3726
Phone (646) 426-3876

Other practice location 1

175 Belgrove Dr
Kearny, NJ 07032-1507
Phone (201) 216-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150501001825 NY Practitioner - Nurse Practitioner 0547589111 Reassigns benefits to 2 organizations
I20260507001513 NJ Practitioner - Nurse Practitioner 0547589111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (800) 300-0628

5 E 98TH St 2ND FL
New York, NY 10029-6501
Phone (212) 241-4572

51 W 51St St
FL 3 Suite 360
New York, NY 10019-6113
Phone (212) 326-8426

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
559461NYMDRegistered Nurse
26NJ1254900NJMDAdult Health Nurse Practitioner
26NJ01254900NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1468 Madison Ave
Fl 2
New York, NY 10029
Phone (212) 241-0300

1468 Madison Ave
Fl 4
New York, NY 10029
Phone (212) 241-6936

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: smp2003@direct.nyp.org

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1639587082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "646-426-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "646-426-3876",
            "fax_number": "212-305-2792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Belgrove Dr",
            "address_purpose": "LOCATION",
            "city": "Kearny",
            "state": "NJ",
            "postal_code": "070321507",
            "country_code": "US",
            "telephone_number": "201-216-9500",
            "fax_number": "201-216-9656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SHAWANDA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "559461",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ1254900",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307009",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01254900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.