Individual provider Active NPI

Shirley Louis

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1194136317
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301504515 Issued in MI
Practice address
1625 Eastchester Rd
Bronx, NY 10461-2604
Phone
(718) 904-4032
NPI assigned
May 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301504515 MI Primary
Neonatal-Perinatal Medicine Physician 2080N0001X 111104 GA

Addresses

Primary practice location

1625 Eastchester Rd
Bronx, NY 10461-2604

Mailing address

619 Matteline St
Uniondale, NY 11553-2618
Phone (516) 770-4094

Other practice location 1

Hsc T 11 Rm 040
Stony Brook, NY 11794-0001
Phone (631) 444-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920001517 MI Practitioner - Pediatric Medicine 4183996697 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Aug 1, 2021 Accepting new patients
University Pediatricians Pediatrics CurrentSince Aug 1, 2021 Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients
VHS Childrens Hospital of Michigan Inc Past Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Organizations & group practices 4

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": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1194136317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MATTELINE ST",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115532618",
            "telephone_number": "516-770-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612604",
            "telephone_number": "718-904-4032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hsc T 11 Rm 040",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301504515",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "111104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.