Individual provider Active NPI

Kiabett Shantall Peguero, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1417866427
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
131336 Issued in NY
Practice address
234 E 149TH St FL 4
Bronx, NY 10451-5589
Phone
(844) 692-4692
NPI assigned
Sep 4, 2026
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131336 NY Primary

Addresses

Primary practice location

234 E 149TH St FL 4
Bronx, NY 10451-5589

Mailing address

590 E 166TH St Apt 5M
Bronx, NY 10456-5682
Phone (646) 355-6266

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": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1417866427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 E 166TH ST APT 5M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565682",
            "telephone_number": "646-355-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST FL 4",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515589",
            "telephone_number": "844-692-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUERO",
        "first_name": "KIABETT",
        "middle_name": "SHANTALL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "131336",
            "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 Sep 4, 2026; 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.