Individual provider Active NPI

Shawn Michael Allen, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1548423577
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
265692 Issued in NY
Practice address
200 Varick St
Project Renewal - 9TH Floor
New York, NY 10014-4810
Phone
(212) 620-0340
NPI assigned
Jul 9, 2008
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 049018 CT
Psychiatry Physician 2084P0800X 265692 NY Primary

Addresses

Primary practice location

200 Varick St
Project Renewal - 9TH Floor
New York, NY 10014-4810

Mailing address

200 Varick St
Project Renewal - 9TH Floor
New York, NY 10014-4810
Phone (212) 620-0340

Other identifiers 1

IdentifierTypeStateIssuer
265692OtherNYNY LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140410001907 NY Practitioner - Psychiatry 4486770468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049018CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1548423577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VARICK ST",
            "address_2": "PROJECT RENEWAL - 9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144810",
            "telephone_number": "212-620-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VARICK ST",
            "address_2": "PROJECT RENEWAL - 9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144810",
            "telephone_number": "212-620-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "049018",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "265692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "265692",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.