Active NPI
Tony Shenderovich
- Art Therapist
- Brewster, NY
National Provider Identifier
1316528987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- Practice address
- 400 Doansburg Rd
Brewster, NY 10509-5902 - Phone
- (845) 279-2995
- NPI assigned
- Apr 15, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Art Therapist | 221700000X | NY | Primary |
Addresses
Primary practice location
400 Doansburg Rd
Brewster, NY 10509-5902
Mailing address
29 Middlebush Rd
Wappingers Falls, NY 12590-4044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tshenderovich@greenchimneys.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1316528987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 MIDDLEBUSH RD",
"city": "WAPPINGERS FALLS",
"state": "NY",
"postal_code": "125904044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 DOANSBURG RD",
"city": "BREWSTER",
"state": "NY",
"postal_code": "105095902",
"telephone_number": "845-279-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENDEROVICH",
"first_name": "TONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tshenderovich@greenchimneys.org",
"affiliation": "N",
"address_1": "400 Doansburg Rd",
"city": "Brewster",
"state": "NY",
"country_code": "US",
"postal_code": "105095902",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brewster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.