Individual provider Active NPI

Danial Shaukat, FNP

  • Family Nurse Practitioner
  • Woodside, NY
National Provider Identifier
1891370664
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347164 Issued in NY
Practice address
3908 56TH St
Woodside, NY 11377-3346
Phone
(917) 239-7034
NPI assigned
Mar 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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 347164 NY Primary

Addresses

Primary practice location

3908 56TH St
Woodside, NY 11377-3346

Mailing address

3908 56TH St
Woodside, NY 11377-3346
Phone (917) 239-7034

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
347164NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of New York, Inc. CurrentSince Jul 15, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

5232 Witz Dr
North Syracuse, NY 13212
Phone (315) 632-5960

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1891370664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 56TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773346",
            "telephone_number": "917-239-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 56TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773346",
            "telephone_number": "917-239-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUKAT",
        "first_name": "DANIAL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-13",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.