Individual provider Active NPI

Monika Gustab, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1972060721
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
331046 Issued in NY
Practice address
265 Ashland PL
Brooklyn, NY 11217-1661
Phone
(718) 858-7200
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 331046 NY Primary

Addresses

Primary practice location

265 Ashland PL
Brooklyn, NY 11217-1661

Mailing address

7800 Shore Front Pkwy Apt 6a
Rockaway Beach, NY 11693-2013
Phone (917) 951-7816

Other practice location 1

7800 Shore Front Pkwy Apt 6A
Rockaway Beach, NY 11693-2013
Phone (917) 951-7816

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
331046NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Health Center Pharmacy Past Accepting new patients
Brooklyn Health Center Past Accepting new patients

Organizations & group practices 2

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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1972060721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 SHORE FRONT PKWY APT 6A",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116932013",
            "telephone_number": "917-951-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 ASHLAND PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171661",
            "telephone_number": "718-858-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 Shore Front Pkwy Apt 6A",
            "address_purpose": "LOCATION",
            "city": "Rockaway Beach",
            "state": "NY",
            "postal_code": "116932013",
            "country_code": "US",
            "telephone_number": "917-951-7816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAB",
        "first_name": "MONIKA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "331046",
            "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 Feb 28, 2019; 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.