Shannon Roesch, DPM PC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

N005991 Issued in NY

Legal business name

SHANNON ROESCH, DPM PC

Practice address

242 Jericho Tpke
Floral Park, NY 11001-2147

Phone

(516) 488-6290

Fax

(516) 488-3172

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Shannon Roesch, MDNPI 1992876239

Title

Dr

Phone

(516) 488-6290

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Roesch, DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Floral Park, NY
  • NPI 1992876239
  Medicare reassignment Authorized official
• Alan Michael Stern, DPM

  • Podiatrist
  • Floral Park, NY
  • NPI 1720086754
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1235296526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012147",
            "telephone_number": "516-488-6290",
            "fax_number": "516-488-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012147",
            "telephone_number": "516-488-6290",
            "fax_number": "516-488-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON ROESCH, DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "ROESCH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "516-488-6290",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N005991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1779083",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7444873",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199",
            "identifier": "00599165NY",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0151722",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "N005991",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3722100",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "6C1150",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "PL2751",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shafique Medical PLLC
• Kevalee Shah
• Yahya Farooq Shah
• Sophia Shamayev, M.S. ED
• Marie Shanahan
• Arthur V Shapiro, RPH
• Louis Shapiro, DDS
• Shakaibullah Sharief, PA-C
• M Naser Sharifi, DDS
• Mehak Sharma

• Foot Surgery Podiatrist in Floral Park, NY
• Providers in Floral Park, NY by specialty
• Foot Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.