Individual provider Active NPI

Bella Shalamova, FNP

  • Family Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1861850513
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340278 Issued in NY
Practice address
6416 110TH St FL 1
Forest Hills, NY 11375-1414
Phone
(646) 270-2162
NPI assigned
Feb 9, 2016
Last updated
Feb 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 340278 NY Primary

Addresses

Primary practice location

6416 110TH St FL 1
Forest Hills, NY 11375-1414

Mailing address

6416 110TH St FL 1
Forest Hills, NY 11375-1414
Phone (646) 270-2162

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
I20210819001974 NY Practitioner - Nurse Practitioner 7911302500 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
340278NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Five Towns Neurology, PC CurrentSince Aug 3, 2021 Accepting new patients

Locations

923 Broadway
Woodmere, NY 11598
Phone (516) 218-2163

923 Broadway
Ste B
Woodmere, NY 11598
Phone (516) 239-1800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDEBBA

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, 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": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1861850513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 110TH ST FL 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751414",
            "telephone_number": "646-270-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6416 110TH ST FL 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751414",
            "telephone_number": "646-270-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALAMOVA",
        "first_name": "BELLA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.