Individual provider Active NPI

Sheva Wenger

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1821636960
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1171 E 19TH St
Brooklyn, NY 11230-4901
Phone
(917) 588-1975
NPI assigned
Dec 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1171 E 19TH St
Brooklyn, NY 11230-4901

Mailing address

1171 E 19TH St
Brooklyn, NY 11230-4901

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
I20220803001754 NY Practitioner - Physician Assistant 9830571132 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027203NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Sep 13, 2023 Accepting new patients
Hasc Diagnostic &Treatment Center, Inc CurrentSince Sep 13, 2023 Accepting new patients
Refuah Health Center, Inc. CurrentSince Jun 12, 2022 Accepting new patients
Refuah Health Center, Inc. Past Accepting new patients

Locations

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

728 N Main St
Ste C
New Square, NY 10977
Phone 84535493001826

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1821636960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304901",
            "telephone_number": "917-588-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "SHEVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.