Jess P Shatkin, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

239112 Issued in NY

Practice address

577 1St Ave
New York, NY 10016-6404

Phone

(212) 263-6567

NPI assigned

Apr 13, 2007

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

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

Interoperability endpoints

• Direct secure messaging: jshatkin44243@nyumc.direct-ci.com

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881818433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166404",
            "telephone_number": "212-263-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166404",
            "telephone_number": "212-263-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATKIN",
        "first_name": "JESS",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "239112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidhi Bankimbhai Shastri
• Siri Shastry, M.D.
• Gabrielle Rebecca Shatan, PH.D.
• Hanya Jean Shatara, LMSW
• Marina Shatbsky, RN
• Michael Stephen Shatkin, MD
• Elizabeth Shats
• Lenny Shats, PHARM.D.
• Tara Nicole Shattuck, MPS, RD, LDN
• Lisa Goldman Shatz, PT, MSPT, CCS

• Child & Adolescent Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.