Individual provider Active NPI

Saheed Shittu

  • Psychiatric/Mental Health Nurse Practitioner
  • Fulshear, TX
National Provider Identifier
1952644593
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405857 Issued in NY
Practice address
30235 Liatris Bend LN
Fulshear, TX 77423-2914
Phone
(718) 737-4581
NPI assigned
Apr 2, 2013
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 308614 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0101067 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1117014 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405857 NY Primary

Addresses

Primary practice location

30235 Liatris Bend LN
Fulshear, TX 77423-2914

Mailing address

30235 Liatris Bend LN
Fulshear, TX 77423-2914
Phone (718) 737-4582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240823001821 ID Practitioner - Nurse Practitioner 7012456973 Reassigns benefits to 2 organizations
I20241220003059 NY Practitioner - Nurse Practitioner 7012456973 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
308614NYMDLicensed Practical Nurse
APN.0101067COMDPsychiatric/Mental Health Nurse Practitioner
F405857NYMDPsychiatric/Mental Health Nurse Practitioner
1117014TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Oct 19, 2024 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Essen Medical Associates,PC CurrentSince Oct 19, 2024 Accepting new patients
Shakespeare Operating LLC CurrentSince Oct 19, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 19, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Oct 19, 2024 Accepting new patients
Azure Stone Mental Health & Wellness LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

950 W Bannock St
Boise, ID 83702
Phone (208) 602-7007

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

2000 S Eagle Rd
Meridian, ID 83642
Phone (208) 539-6557

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Networks

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

Organizations & group practices 8

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1952644593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30235 LIATRIS BEND LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774232914",
            "telephone_number": "718-737-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30235 LIATRIS BEND LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774232914",
            "telephone_number": "718-737-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHITTU",
        "first_name": "SAHEED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "308614",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0101067",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1117014",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulshear, TX

Sources for this page

Verify at the official NPI Registry.