1. Home
  2. Directory
  3. New York
  4. Staten Island
  5. Obstetrics Gynecology
  6. NPI Profile

SHOURON HELENA GHASSEMLOU MD
NPI 1316511694
Obstetrics & Gynecology in Staten Island, NY

Active since May 19, 2021PECOS EnrolledAccepts Medicare Assignment
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR, STATEN ISLAND, NY 10310(718) 818-2419 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 4, 2025, May 19, 2021 (2 updates tracked since 2021).

About Shouron Helena Ghassemlou Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOURON HELENA GHASSEMLOU MD (NPI 1316511694) is an individual obstetrics & gynecology provider in Staten Island, New York, licensed in New York (339768-01) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Staten Island, and is a graduate of Medical College Of Georgia School Of Medicine (2021).

NPPES Registry Identity

NPI1316511694
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameSHOURON HELENA GHASSEMLOUCredential: MD
Location Address355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOORStaten Island, NY 10310
Mailing Address355 Bard Avenue, Department Of Medicine Villa Bldg 1st FloorStaten Island, NY 10310
Phone(718) 818-2419
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2021
Enumeration DateMay 19, 2021
Last NPPES UpdateDecember 4, 20252 updates tracked since enumeration
NPPES CertifiedDecember 4, 2025
✔ NPI 1316511694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in NY · 339768-01
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
355 BARD AVENUE, Staten Island, NY 10310
Open in Google Maps ↗

Secondary Practice Location 1

Location 12935 Veterans Rd W Ste HStaten Island, NY 10309-2514 · Phone (718) 818-4361 · Fax (833) 428-3969

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shouron Helena Ghassemlou Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810473576
PECOS Enrollment IDI20260113000140
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shouron Ghassemlou reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Amboy Medical Practice PC
Same address
Diagnostic Radiology
355 BARD AVE
Staten Island, NY 10310
  • Reassigned Medicare billing, New York enrollment
  • 305 clinicians in this Medicare group
NPI 1104692672 (718) 818-1234

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10310 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN CAWTHORN DO
Student in an Organized Health Care Education/Training Program
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
SU LAT AUNG MD
Hospitalist
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
MORGAN KLINGFUS MD
Student in an Organized Health Care Education/Training Program
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
ANTONIA KRISTINE BERTELLE MD
Internal Medicine
355 BARD AVENUE, DEPARTMENT OF MEDICINE , VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
ANISSA ABDELMALEK MD
Pathology (Anatomic Pathology & Clinical Pathology)
355 BARD AVENUE
STATEN ISLAND, NY 10310
Richmond County (516) 512-1090
RUSHANIYA UMYAROVA MD
Internal Medicine
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
DR. AVA ELYSE HANLON DO
Student in an Organized Health Care Education/Training Program
355 BARD AVENUE, DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419
ROOSHNA FIRDOUS FATIMA MD
Student in an Organized Health Care Education/Training Program
355 BARD AVENUE, ROOM 477
STATEN ISLAND, NY 10310
Richmond County (718) 818-2419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shouron Ghassemlou's NPI number?

The NPI number for Shouron Ghassemlou is 1316511694. It was assigned to this individual provider in the NPPES registry on May 19, 2021.

Where is Shouron Ghassemlou located?

Shouron Ghassemlou practices at 355 Bard Avenue Department Of Medicine Villa Bldg 1st Floor, Staten Island, NY 10310. The listed phone number is (718) 818-2419.

What is Shouron Ghassemlou's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Shouron Ghassemlou enrolled in Medicare?

Yes. Shouron Ghassemlou is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shouron Ghassemlou's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shouron Ghassemlou reassigns Medicare benefits to Amboy Medical Practice PC (Staten Island, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shouron Ghassemlou's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shouron Ghassemlou was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.