Shaniece Degazon, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01788400 Issued in NJ

Practice address

45 South Ave W Ste 101
Cranford, NJ 07016-2686

Phone

(908) 709-7300

NPI assigned

Jun 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthspark Medical Group West PCGroup PAC ID 6608385513, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthspark Medical Group West PC

  • Physical Therapy Clinic/Center
  • San Jose, CA
  • NPI 1174338842

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Prosynergy Physical Therapy LLC

  • Physical Therapist
  • Cranford, NJ
  • NPI 1235515529

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1003308206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 WOODHAVEN DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705166",
            "telephone_number": "609-558-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SOUTH AVE W STE 101",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162686",
            "telephone_number": "908-709-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGAZON",
        "first_name": "SHANIECE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01788400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Hausen De Mello Salgueiro, L.P.C.
• Cristina De Oliveira
• Dominick Anthony Deblasio, LPC LCADC
• Maria Decena
• Norman L Decker, D.C.
• Gabriel Delisa, BCBA, LBA
• Chelsae Marie Dell Elba, M.S. CCC-SLP
• Olivia Deluca
• Kayla Miriam Denigris, RDN
• Dent D' Elite LLC

• Physical Therapist in Cranford, NJ
• Providers in Cranford, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.