Individual provider Active NPI

Shaneka Gregory, NP

  • Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1841835691
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F309067-1 Issued in NY
Practice address
6740 4TH Ave FL 3
Brooklyn, NY 11220-5350
Phone
(929) 455-2700
NPI assigned
Nov 14, 2019
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F309067-1 NY Primary

Addresses

Primary practice location

6740 4TH Ave FL 3
Brooklyn, NY 11220-5350

Mailing address

9821 Avenue K
Brooklyn, NY 11236-4407
Phone (347) 721-5751

Other practice location 1

9821 Avenue K
Brooklyn, NY 11236-4407
Phone (347) 721-5751

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgregory501077@nyumc.direct-ci.com Direct

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
I20220510000825 NY Practitioner - Nurse Practitioner 2961889118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F309067-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 9, 2022 Accepting new patients
New York University CurrentSince May 9, 2022 Accepting new patients

Locations

6740 4th Ave
Fl 3
Brooklyn, NY 11220
Phone (929) 455-2700

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1841835691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 AVENUE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364407",
            "telephone_number": "347-721-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 4TH AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205350",
            "telephone_number": "929-455-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9821 Avenue K",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112364407",
            "country_code": "US",
            "telephone_number": "347-721-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "SHANEKA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F309067-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgregory501077@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6740 4th Ave Fl 3",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112205350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.