Shanequa Boone

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403688-01 Issued in NY

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(516) 333-5555

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Shanequa Wilson Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Board of Family and Childrens Services IncGroup PAC ID 5092607333, 127 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.65 of 100Reported as group

Quality

71.56

Promoting interoperability

74

Improvement activities

40

Cost

87.55

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.

• Jewish Board of Family & Childrens Services Inc

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1689755662
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  NY

  Medicare reassignment NPD
• Psychiatric Care Medical PLLC

  • Psychiatry Physician
  • Saint James, NY
  • NPI 1952946386
  Medicare reassignment NPD
• Saboone NP in Psychiatry, PLLC

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1447016738
  NPD Authorized official
• Jewish Board of Family and Children'S Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Brooklyn, NY
  • NPI 1760173579

  Psychiatric/Mental Health

  NPD
• New York Neuromodulation Medical PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1558891135
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1174059919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "516-333-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "SHANEQUA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "341543",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403688-01",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANEQUA",
            "last_name": "WILSON",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tonia Boike, LPCC
• Melissa Bolles
• Samuel Bomber, LPCC
• Caycee Jo Bonacci
• Eva Marina Boncich
• Mara Ann Boonstra, PT, DPT
• Michael Robert Borowiak, MSW, LICSW
• Christina J Bortone, NP
• Brooke Bosek
• Paul Both

• Psychiatric/Mental Health Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.
• 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.