Individual provider Active NPI

Brooke Eryn Shmuel, BS, MS CCC-SLP

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1053855619
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011934-01 Issued in NY
Practice address
4011 Monticello Ave
Bronx, NY 10466-2303
Phone
(718) 324-2854
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 011934-01 NY Primary

Addresses

Primary practice location

4011 Monticello Ave
Bronx, NY 10466-2303

Mailing address

4011 Monticello Ave
Bronx, NY 10466-2303
Phone (718) 324-2854

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
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
011934-01NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1053855619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 MONTICELLO AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662303",
            "telephone_number": "718-324-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 MONTICELLO AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662303",
            "telephone_number": "718-324-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHMUEL",
        "first_name": "BROOKE",
        "middle_name": "ERYN",
        "credential": "BS, MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011934-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.