Active NPI
Deborah Michelle Shatkin, M.D.
- Pediatrics Physician
- Bronx, NY
National Provider Identifier
1306062104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 204260
- Practice address
- 3424 Kossuth Ave
North Central Bronx Pediatric ER
Bronx, NY 10467-2410 - Phone
- (718) 519-3015
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 204260 | NY | Primary |
Addresses
Primary practice location
3424 Kossuth Ave
North Central Bronx Pediatric ER
Bronx, NY 10467-2410
Mailing address
17 Marisa Dr
Spring Valley, NY 10977-1006
Phone (845) 362-6938
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110419000056 | NY | Order and Referring Only - Pediatric Medicine | 6305020280 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204260 | NY | MD | Pediatrics Physician |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306062104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MARISA DR",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109771006",
"telephone_number": "845-362-6938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3424 KOSSUTH AVE",
"address_2": "NORTH CENTRAL BRONX PEDIATRIC ER",
"city": "BRONX",
"state": "NY",
"postal_code": "104672410",
"telephone_number": "718-519-3015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHATKIN",
"first_name": "DEBORAH",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "204260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.