Individual provider Active NPI

Mariya Shtuchko, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1780395665
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049895-01 Issued in NY
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

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
049895NYMDPharmacist
049895-01NYMDGeriatric 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.

Verify at the official NPI Registry.