Individual provider Active NPI

Shauna Coke, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hyde Park, NY
National Provider Identifier
1619219649
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401967 Issued in NY
Practice address
11 Crum Elbow Rd
Hyde Park, NY 12538-2852
Phone
(845) 229-1020
NPI assigned
Mar 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F3374881 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401967 NY Primary

Addresses

Primary practice location

11 Crum Elbow Rd
Hyde Park, NY 12538-2852

Mailing address

123 W 124TH St
New York, NY 10027-4920

Other names 1

  • Shauna Roach Former name

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
I20171107002669 NY Practitioner - Nurse Practitioner 0042576027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

1894 Walton Ave
Bronx, NY 10453-6018
Phone (718) 583-3060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F3374881NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Sep 12, 2017 Accepting new patients
The Institute for Family Health CurrentSince Sep 12, 2017 Accepting new patients
The Institute for Family Health Current Accepting new patients
Harlem United Com AIDS Ctr Ai Past Accepting new patients

Locations

1894 Walton Ave
Bronx, NY 10453
Phone (718) 583-2508

11 Crum Elbow Rd
Hyde Park, NY 12538
Phone (845) 229-1020

279 Main St
Ste 101
New Paltz, NY 12561
Phone (845) 255-2930

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

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.

NPI Registry JSON

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

{
    "created_epoch": "1363392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1619219649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CRUM ELBOW RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125382852",
            "telephone_number": "845-229-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKE",
        "first_name": "SHAUNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F3374881",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUNA",
            "last_name": "ROACH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.