Individual provider Active NPI

Shelley J Epstein, MD

  • Psychiatry Physician
  • Smithtown, NY
National Provider Identifier
1255407987
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
173422 Issued in NY
Practice address
222 Middle Country Rd
Suite 210
Smithtown, NY 11787-2814
Phone
(631) 265-6868
Fax
(631) 265-6890
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 173422 NY Primary

Addresses

Primary practice location

222 Middle Country Rd
Suite 210
Smithtown, NY 11787-2814

Mailing address

222 Middle Country Rd
Suite 210
Smithtown, NY 11787-2814
Phone (631) 265-6868

Other identifiers 1

IdentifierTypeStateIssuer
01202666MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120110000466 NY Practitioner - PsychiatryPractitioner - Addiction Medicine 8325226111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Psychiatric Consultants PC Psychiatry CurrentSince Jul 21, 1980 Accepting new patients

Locations

222 E Middle Country Rd
Ste 210
Smithtown, NY 11787
Phone (631) 265-6868

180 E Main St
Ste 302
Smithtown, NY 11787
Phone (631) 265-6868

Interoperability endpoints

  • Direct secure messaging: sepstein14383@direct-chsli.net

Organizations & group practices 1

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1255407987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MIDDLE COUNTRY RD",
            "address_2": "SUITE 210",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872814",
            "telephone_number": "631-265-6868",
            "fax_number": "631-265-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MIDDLE COUNTRY RD",
            "address_2": "SUITE 210",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872814",
            "telephone_number": "631-265-6868",
            "fax_number": "631-265-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "SHELLEY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "173422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01202666",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.