Melissa Anne Shongut

Primary specialty

Social WorkerTaxonomy code 104100000X

License

4567 Issued in CT

Practice address

30 Elizabeth St
Derby, CT 06418-1802

Phone

(203) 954-0543

NPI assigned

Jan 7, 2019

Sex

Female

Sole proprietor

No

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 CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Clifford W. Beers Guidance Clinic Inc

  • Adolescent and Children Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1073526968
  Medicare reassignment NPD

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1053884692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 RUFF CIR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181802",
            "telephone_number": "203-954-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHONGUT",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "4567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pete Prashamsa Shenoy, M.D.
• Natalia Aleksandrovna Sheptukhina, APRN
• Shilpa Shetty, MD
• Yosep Shin, M.D.
• Firoozeh Shomal Zadeh
• Bianca N Shuster, APRN
• Aanu Sihota, M.D.
• Angelina R Silva, FNP-BC
• Julie Sim, CRNA
• Margot A Simeone

• Social Worker in Derby, CT
• Providers in Derby, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.