Active NPI
Shelly Ann Uter, NP
- Adult Health Nurse Practitioner
- Brooklyn, NY
National Provider Identifier
1801008040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F303119
- Practice address
- 374 Stockholm St
Brooklyn, NY 11237-4006 - Phone
- (718) 963-7272
- NPI assigned
- May 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F303119 | NY | Primary |
Addresses
Primary practice location
374 Stockholm St
Brooklyn, NY 11237-4006
Mailing address
42 Goshen St
Elmont, NY 11003-5025
Phone (516) 825-4235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F303119 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyckoff Professional Medical Services, PC | Current | Accepting new patients |
Locations
374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485
7554 Metropolitan Ave
Middle Vlg, NY 11379
Phone (718) 326-0400
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1659710796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801008040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 GOSHEN ST",
"city": "ELMONT",
"state": "NY",
"postal_code": "110035025",
"telephone_number": "516-825-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 STOCKHOLM ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374006",
"telephone_number": "718-963-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTER",
"first_name": "SHELLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F303119",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.