Individual provider Active NPI

Maria Shalukhova, AGNP, PMHNP

  • Adult Health Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1700268778
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307294 Issued in NY
Practice address
25 Bank St Apt 212B
White Plains, NY 10606-7004
Phone
(716) 380-7874
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404459 NY
Adult Health Nurse Practitioner 363LA2200X 307294 NY Primary

Addresses

Primary practice location

25 Bank St Apt 212B
White Plains, NY 10606-7004

Mailing address

25 Bank St Apt 212B
White Plains, NY 10606-7004
Phone (716) 380-7874

Other practice location 1

4248 Ridge Lea Rd
Suite 126
Amherst, NY 14226-1053
Phone (716) 833-3237

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
I20150922002654 NY Practitioner - Nurse Practitioner 4587971668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Healthcare Services P.C.Group PAC ID 7012185366, 16 clinicians

Practice addresses (Care Compare)

157 E 72ND St
New York, NY 10021-4333
Phone (718) 239-0030

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
67.92
Improvement activities
40
Cost
65.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307294NYMDAdult Health Nurse Practitioner
404459NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Healthcare Services P.C. CurrentSince Aug 1, 2022 Accepting new patients
Mobile Primary Care Family Nurse Practitioners, PLLC CurrentSince Aug 15, 2015 Accepting new patients
Shalukhova NP in Adult Health and NP in Psychiatry PLLC CurrentSince May 26, 2024 Accepting new patients
Medical Director Services PC CurrentSince Feb 10, 2020 Accepting new patients
Stall Senior Medical LLC PastSince Aug 1, 2008 Accepting new patients

Locations

612 Allerton Ave
Bronx, NY 10467
Phone (718) 519-4125

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

640 Ellicott St
Ste 105
Buffalo, NY 14203
Phone (716) 218-7169

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

4650 Southwestern Blvd
Hamburg, NY 14075
Phone (716) 648-2450

14445 87th Ave
Jamaica, NY 11435
Phone (718) 239-0030

Organizations & group practices 5

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1700268778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BANK ST APT 212B",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106067004",
            "telephone_number": "716-380-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BANK ST APT 212B",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106067004",
            "telephone_number": "716-380-7874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4248 Ridge Lea Rd",
            "address_2": "Suite 126",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142261053",
            "country_code": "US",
            "telephone_number": "716-833-3237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALUKHOVA",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "AGNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404459",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.