Individual provider Active NPI

Shayna Shaffer

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1942757216
Registry record updated Sep 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
858876141 Issued in NY
Practice address
470 Lefferts Ave
Brooklyn, NY 11225-4407
Phone
(718) 735-0770
NPI assigned
Sep 5, 2016
Last updated
Sep 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 858876141 NY Primary

Addresses

Primary practice location

470 Lefferts Ave
Brooklyn, NY 11225-4407

Mailing address

711 Montgomery St
Brooklyn, NY 11213-5103
Phone (347) 416-0697

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

State licenses

LicenseStateTypeSpecialty
858876141NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Crown Multieducational Services Past Accepting new patients

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": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1942757216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MONTGOMERY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135103",
            "telephone_number": "347-416-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 LEFFERTS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112254407",
            "telephone_number": "718-735-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "SHAYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "858876141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2016; 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.