Individual provider Active NPI

Shawna-Lee Tamar Feanny, NURSE PRACTITIONER

  • Licensed Practical Nurse
  • Rockville Centre, NY
National Provider Identifier
1376795245
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
274544 Issued in NY
Practice address
1000 N Village Ave
Rockville Centre, NY 11570-1000
Phone
(516) 705-2525
NPI assigned
Oct 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 610980 NY
Acute Care Nurse Practitioner 363LA2100X 432409 NY
Licensed Practical Nurse 164W00000X 274544 NY Primary

Addresses

Primary practice location

1000 N Village Ave
Rockville Centre, NY 11570-1000

Mailing address

160 Hofstra University
Hempstead, NY 11549-1600
Phone (516) 647-3951

Other practice location 1

23218 Merrick Blvd
Laurelton, NY 11413-2115
Phone (718) 528-3432

Other identifiers 1

IdentifierTypeStateIssuer
010556898MedicaidNY

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
I20230609001805 NY Practitioner - Nurse Practitioner 0042677833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PC 341 clinicians
New Health Medical PC 3 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-3656

6918 32ND Ave
Woodside, NY 11377-2033
Phone (718) 639-9100

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
610980NYMDRegistered Nurse
274544NYMDLicensed Practical Nurse

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince May 1, 2023 Accepting new patients
New Health Medical PC CurrentSince Jan 3, 2024 Accepting new patients
Verdun Home Health Care Inc Past Accepting new patients
Verdun Home Health Care Inc Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

41 Maine Ave
Rockville Ctr, NY 11570
Phone (516) 536-7730

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1376795245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HOFSTRA UNIVERSITY",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115491600",
            "telephone_number": "516-647-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701000",
            "telephone_number": "516-705-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23218 Merrick Blvd",
            "address_purpose": "LOCATION",
            "city": "Laurelton",
            "state": "NY",
            "postal_code": "114132115",
            "country_code": "US",
            "telephone_number": "718-528-3432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEANNY",
        "first_name": "SHAWNA-LEE",
        "middle_name": "TAMAR",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "610980",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432409",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "274544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010556898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.