Phaedra Sirju

Primary specialty

DoulaTaxonomy code 374J00000X

Practice address

18619 122ND Ave
Springfield Gardens, NY 11413-1074

Phone

(917) 254-1398

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1679146799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18619 122ND AVE",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18619 122ND AVE",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131074",
            "telephone_number": "917-254-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRJU",
        "first_name": "PHAEDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxann Sheppard-Samuel, LCSW
• Esante Shields
• Stephanie Shivamber
• Kedesha Siddiqui
• Brittany Antoinette Sims
• Carmiter Ciciley Smith
• Natasha Smith, LPN
• Social Concern Community Development
• Social Concern Vendor Agency, Inc.
• Marshialyn Georgia Spencer-Kelly, LPN

• Doula in Springfield Gardens, NY
• Providers in Springfield Gardens, NY by specialty
• Doula in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.