Dershawn Sibblies

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

656 Ave Ponce de Leon Ste 1
San Juan, PR 00918-4522

Phone

(788) 998-8997

NPI assigned

Sep 1, 2025

Last updated

Sep 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1225917404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 HUNGRY HARBOR RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813637",
            "telephone_number": "516-373-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 AVE PONCE DE LEON STE 1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184522",
            "telephone_number": "788-998-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBBLIES",
        "first_name": "DERSHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-01",
        "last_updated": "2025-09-01",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SHC at Home
• SHC Imagine Center
• SHC Mental & Health Care
• SHC Vaccination Center
• Leonel Shub, MD
• Sick Blood Med Serv CSP
• Yaina Sierra Cordova, MD
• Aslee Sierra Gonzalez
• Kassandra Sierra Martinez, M.D.
• Marielly Sierra Mercado, M.D.

• Student in an Organized Health Care Education/Training Program in San Juan, PR
• Providers in San Juan, PR by specialty
• Student in an Organized Health Care Education/Training Program in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; 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.