Alexandra Shustina, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

255074-1 Issued in NY

Practice address

506 Malcolm X Blvd
Harlem Hospital
New York, NY 10037

Phone

(212) 939-1430

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1861629495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M302",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-276-0000",
            "fax_number": "269-276-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "HARLEM HOSPITAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10037",
            "telephone_number": "212-939-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTINA",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "255074-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rickie Sue Shuster, PSYD
• Victoria Shuster
• David Shusterman, M.D.
• Lana Shusterman
• Michael Shusterman, M.D.
• Yevgeniy Shustorovich, MD
• Gillian Shuty, FNP-C
• Elizabeth Sara Shuzman, LCSW
• Alexander Shvarts, M.D.
• Genrich Shvarts, DDS

• All providers in New York, NY
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.