Individual provider Active NPI

Regina Shakarova

  • Case Manager/Care Coordinator
  • Rego Park, NY
National Provider Identifier
1861827404
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
9609 66TH Ave Apt 6D
Rego Park, NY 11374-4114
Phone
(917) 916-0780
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

9609 66TH Ave Apt 6D
Rego Park, NY 11374-4114

Mailing address

9609 66TH Ave Apt 6D
Rego Park, NY 11374-4114
Phone (917) 916-0780

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1861827404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9609 66TH AVE APT 6D",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744114",
            "telephone_number": "917-916-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9609 66TH AVE APT 6D",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744114",
            "telephone_number": "917-916-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKAROVA",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.