Individual provider Active NPI

Shelly Doron, MS-CCC-SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1205379864
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
025974-1 Issued in NY
Practice address
51 Saint Edwards St
Brooklyn, NY 11205-2932
Phone
(718) 834-6756
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 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 025974-1 NY Primary

Addresses

Primary practice location

51 Saint Edwards St
Brooklyn, NY 11205-2932

Mailing address

51 Saint Edwards St
Brooklyn, NY 11205-2932
Phone (718) 834-6756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823000432 NY Practitioner - Qualified Speech Language Pathologist 0446522601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025974NYMDCognitive & Behavioral Psychologist
025974-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hasc Diagnostic &Treatment Center, Inc CurrentSince Jul 11, 2017 Accepting new patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Jul 11, 2017 Accepting new patients

Locations

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

Organizations & group practices 2

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1205379864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SAINT EDWARDS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052932",
            "telephone_number": "718-834-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SAINT EDWARDS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052932",
            "telephone_number": "718-834-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORON",
        "first_name": "SHELLY",
        "name_prefix": "Ms.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025974-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.