Individual provider Active NPI

Shaconda Michelle Junious, M.D

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1467747287
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35201 Issued in AL
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 270-1421
Fax
(718) 270-2826
NPI assigned
Jun 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 35201 AL Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OK, NC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180130002089 PA Practitioner - Anesthesiology 7911141494
I20190304002144 OK Practitioner - Anesthesiology 7911141494
I20210816002282 NC Practitioner - Anesthesiology 7911141494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3034

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients

Locations

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • Direct secure messaging: sjunious227553@direct.urmc.rochester.edu

Organizations & group practices 3

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 1

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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1467747287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701",
            "fax_number": "205-297-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1421",
            "fax_number": "718-270-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNIOUS",
        "first_name": "SHACONDA",
        "middle_name": "MICHELLE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "35201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.