Individual provider Active NPI

Shaleene Persaud-Vasquez, M.D.

  • General Practice Physician
  • Delray Beach, FL
National Provider Identifier
1265897904
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN719 Issued in FL
Practice address
400 S Swinton Ave
Delray Beach, FL 33444-3553
Phone
(561) 278-0000
NPI assigned
Dec 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN719 FL Primary

Addresses

Primary practice location

400 S Swinton Ave
Delray Beach, FL 33444-3553

Mailing address

586 Edgebrook LN
Wellington, FL 33411-5301
Phone (561) 758-9333

Other practice location 1

6405 W Indiantown Rd Ste B
Jupiter, FL 33458-4040
Phone (561) 203-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN719FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Drug Abuse Foundation PastSince Dec 22, 2019 Accepting new patients
Drug Abuse Foundation of Palm Beach County, Inc PastSince Dec 22, 2019 Accepting new patients

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1265897904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 EDGEBROOK LN",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334115301",
            "telephone_number": "561-758-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S SWINTON AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334443553",
            "telephone_number": "561-278-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6405 W Indiantown Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334584040",
            "country_code": "US",
            "telephone_number": "561-203-7511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD-VASQUEZ",
        "first_name": "SHALEENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.