Individual provider Active NPI

Paula I Schreck

  • Specialist
  • Hauppauge, NY
National Provider Identifier
1083122568
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
93170 Issued in NY
Practice address
495 Hoffman LN
Hauppauge, NY 11788-3102
Phone
(631) 863-3000
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 93170 NY Primary

Addresses

Primary practice location

495 Hoffman LN
Hauppauge, NY 11788-3102

Mailing address

111 Washington Ave
West Sayville, NY 11796-1021
Phone (631) 949-5262

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
93170NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Opportunity Pre-School Past Accepting new patients

Organizations & group practices 1

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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1083122568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WASHINGTON AVE",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961021",
            "telephone_number": "631-949-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HOFFMAN LN",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883102",
            "telephone_number": "631-863-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "PAULA",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "93170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.