Individual provider Active NPI

Shiny Easo, N.P.

  • Family Nurse Practitioner
  • Jackson Heights, NY
National Provider Identifier
1750791992
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338214 Issued in NY
Practice address
3435 70TH St
Jackson Heights, NY 11372-1055
Phone
(718) 651-9700
NPI assigned
Apr 28, 2014
Last updated
Jun 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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 F338214 NY Primary

Addresses

Primary practice location

3435 70TH St
Jackson Heights, NY 11372-1055

Mailing address

268 Clearmeadow Dr
East Meadow, NY 11554-1213

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
I20170124001756 NY Practitioner - Nurse Practitioner 4880976000 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nassau Suffolk Psychiatry PCGroup PAC ID 5991941486, 2 clinicians
South Shore Magnetic Resonance Imaging Associates PCGroup PAC ID 8729991971, 9 clinicians

Practice addresses (Care Compare)

1975 Hempstead Tpke
Suite 208
East Meadow, NY 11554-1703
Phone (516) 222-2747

81 Louden Ave
Amityville, NY 11701-2736
Phone (631) 789-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F338214NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Suffolk Psychiatry PC CurrentSince Jul 1, 2020 Accepting new patients
South Shore Magnetic Resonance Imaging Associates PC CurrentSince Dec 18, 2016 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Nys Office of Mental Health Past Accepting new patients

Locations

81 Louden Ave
Amityville, NY 11701
Phone (631) 789-7000

1975 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 939-8867

1975 Hempstead Tpke
Ste 208
East Meadow, NY 11554
Phone (516) 222-2747

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1750791992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 CLEARMEADOW DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 70TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721055",
            "telephone_number": "718-651-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASO",
        "first_name": "SHINY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.