Individual provider Active NPI

Shannen Katherine Galindo, PA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1245051341
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
032725 Issued in NY
Practice address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone
(718) 589-2440
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 032725 NY Primary

Addresses

Primary practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250620002304 NY Practitioner - Physician Assistant 2961914445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
San Juan Bautista School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Family Medical Center IncGroup PAC ID 7113835380, 61 clinicians

Practice addresses (Care Compare)

5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 632-2737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
032725NYMDGeneral Practice Dentistry

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Open Door Family Medical Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Open Door Family Medical Center, Inc. Past Accepting new patients

Locations

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA

Organizations & group practices 3

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1245051341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALINDO",
        "first_name": "SHANNEN",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "032725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.