Individual provider Active NPI

Shonette Margaret Latoya Miller- Costen, NP

  • Adult Health Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1770770323
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304456 Issued in NY
Practice address
22219 Linden Blvd
Jamaica, NY 11411-1605
Phone
(718) 765-6055
Fax
(347) 808-4948
NPI assigned
Sep 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 304456 NY Primary

Addresses

Primary practice location

22219 Linden Blvd
Jamaica, NY 11411-1605

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

24102 Memphis Ave
Rosedale, NY 11422-2019
Phone (718) 276-0008

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
I20120730000161 NY Practitioner - Nurse Practitioner 1951567379 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
New York University College of Dentistry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

22219 Linden Blvd
Jamaica, NY 11411-1605
Phone (718) 765-6055

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Mar 4, 2019 Accepting new patients
Ion Oltean Physician PC CurrentSince Oct 14, 2019 Accepting new patients
Advantagecare Physicians PC CurrentSince Mar 4, 2019 Accepting new patients
Griffin Myers Medical, P.C. CurrentSince Apr 11, 2022 Accepting new patients
Ny Family Practice Physicians, PC Current Accepting new patients

Locations

22 Robert R Kasin Way
Beacon, NY 12508
Phone (845) 231-5792

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

3515 Parsons Blvd
Flushing, NY 11354
Phone (718) 961-3500

13966 35th Ave
Flushing, NY 11354
Phone (718) 961-5300

22219 Linden Blvd
Jamaica, NY 11411
Phone (718) 765-6055

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

11208 Springfield Blvd
Queens Village, NY 11429
Phone (929) 430-3811

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

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.

Hospital & facility affiliations 1

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1770770323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22219 LINDEN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114111605",
            "telephone_number": "718-765-6055",
            "fax_number": "347-808-4948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24102 Memphis Ave",
            "address_purpose": "LOCATION",
            "city": "Rosedale",
            "state": "NY",
            "postal_code": "114222019",
            "country_code": "US",
            "telephone_number": "718-276-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER- COSTEN",
        "first_name": "SHONETTE",
        "middle_name": "MARGARET LATOYA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.