Individual provider Active NPI

Shahzoda Yuldasheva

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1669238242
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353631 Issued in NY
Practice address
3364 Nostrand Ave
Brooklyn, NY 11229-4004
Phone
(347) 651-9939
NPI assigned
Feb 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 353631 NY Primary

Addresses

Primary practice location

3364 Nostrand Ave
Brooklyn, NY 11229-4004

Mailing address

2480 W 1St St
Brooklyn, NY 11223-5929
Phone (347) 651-9939

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241202002799 NY Practitioner - Nurse Practitioner 1951836840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
353631NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Abdrabou Rehab PT PC CurrentSince Feb 25, 2024 Accepting new patients

Locations

3364 Nostrand Ave
Brooklyn, NY 11229
Phone (347) 570-5348

111 Bay 50th St
Brooklyn, NY 11214
Phone (212) 629-7441

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1669238242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 W 1ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235929",
            "telephone_number": "347-651-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3364 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294004",
            "telephone_number": "347-651-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YULDASHEVA",
        "first_name": "SHAHZODA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.