Active NPI
Mariya Shtuchko, DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1780395665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 049895-01
- Practice address
- 2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552 - Phone
- (347) 523-0744
- NPI assigned
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 049895-01 | NY | |
| Pediatric Physical Therapist | 2251P0200X | 049895-01 | NY | |
| Physical Therapist | 225100000X | 049895-01 | NY | Primary |
Addresses
Primary practice location
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Mailing address
2400 Nostrand Ave Apt 719
Brooklyn, NY 11210-4037
Phone (347) 523-0744
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | securerecords.sanford.html | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049895 | NY | MD | Pharmacist |
| 049895-01 | NY | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1780395665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 NOSTRAND AVE APT 719",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112104037",
"telephone_number": "347-523-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2579 OCEAN AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294552",
"telephone_number": "347-523-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHTUCHKO",
"first_name": "MARIYA",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NY",
"license": "049895-01",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "049895-01",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "049895-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "securerecords.sanford.html",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2579 Ocean Ave Fl 3",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112294552",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.