Individual provider Active NPI

Shira Tova Baradarian, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1790696474
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
036529 Issued in NY
Practice address
2211 Emmons Ave
Brooklyn, NY 11235-2727
Phone
(718) 368-2960
NPI assigned
Sep 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 036529 NY
Surgical Physician Assistant 363AS0400X 036529 NY
Physician Assistant 363A00000X 036529 NY Primary

Addresses

Primary practice location

2211 Emmons Ave
Brooklyn, NY 11235-2727

Mailing address

2211 Emmons Ave
Brooklyn, NY 11235-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1790696474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 EMMONS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 EMMONS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352727",
            "telephone_number": "718-368-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARADARIAN",
        "first_name": "SHIRA",
        "middle_name": "TOVA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "036529",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "036529",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "036529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.