Active NPI
Shauna T Walters, MD
- Pediatrics Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 281628-1
- Practice address
- 3444 Kossuth Ave
Bronx, NY 10467 - Phone
- (718) 920-2273
- NPI assigned
- May 10, 2012
- 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 | 281628-1 | NY | Primary |
Addresses
Primary practice location
3444 Kossuth Ave
Bronx, NY 10467
Mailing address
3444 Kossuth Ave
Bronx, NY 10467-2410
Phone (718) 920-2273
Other practice location 1
3444 Kossuth Ave
Bronx, NY 10467
Phone (718) 920-2273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 281628-1 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little River Medical Center Inc | Current | Accepting new patients | |
| Little River Medical Center, Inc. | Pediatrics | Current | Accepting new patients |
| Montefiore Medical Center | Pediatrics | Current | Accepting new patients |
| Montefiore Medical Center | Current | Accepting new patients | |
| Little River Medical Center, Inc. | Current | Accepting new patients | |
| Little River Medical Center, Inc. | Current | Accepting new patients | |
| Little River Medical Center, Inc | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
3444 Kossuth Ave
Bronx, NY 10467
Phone (718) 920-2273
4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939
3817 Main St
Loris, SC 29569
Phone (843) 663-8297
4220 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 663-8013
3515 Caduceus Dr
Ste B
Myrtle Beach, SC 29588
Phone (843) 651-5689
7724 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 839-3939
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- shwalters@montefioredirect.com
Organizations & group practices 8
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.
-
- Federally Qualified Health Center (FQHC)
- Little River, SC
- NPI 1629021076
-
- Federally Qualified Health Center (FQHC)
- Myrtle Beach, SC
- NPI 1346638483
-
- Federally Qualified Health Center (FQHC)
- Myrtle Beach, SC
- NPI 1184783284
-
- Federally Qualified Health Center (FQHC)
- Myrtle Beach, SC
- NPI 1508120619
Pediatrics
-
- Federally Qualified Health Center (FQHC)
- Loris, SC
- NPI 1619100096
-
- Federally Qualified Health Center (FQHC)
- Myrtle Beach, SC
- NPI 1669535225
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1518226513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3444 KOSSUTH AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672410",
"telephone_number": "718-920-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3444 KOSSUTH AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "10467",
"telephone_number": "718-920-2273"
}
],
"practiceLocations": [
{
"address_1": "3444 Kossuth Ave",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "10467",
"country_code": "US",
"telephone_number": "718-920-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTERS",
"first_name": "SHAUNA",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-10",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "281628-1",
"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 2, 2019; 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.