Melina Shivbaran, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029417 Issued in NY

Practice address

1407 30TH Rd
Astoria, NY 11102-3639

Phone

(646) 644-0349

NPI assigned

Jun 11, 2018

Last updated

Dec 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1710470018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 30TH RD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023639",
            "telephone_number": "646-644-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 30TH RD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023639",
            "telephone_number": "646-644-0349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Austin St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754739",
            "country_code": "US",
            "telephone_number": "718-762-7633 x425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIVBARAN",
        "first_name": "MELINA",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029417",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1230032181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "029417",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stuart Sherman, M.S.
• Drilona Sheti, DDS
• Rajat Shetty, O.D.
• Shining Armor Care Inc
• Shirish Patel Medical P.C.
• Vitaly Shlez, M.D.
• Callie Short
• Natalia Shtompel, M.A.
• Alexandra Leigh Shulman, CCC-SLP
• Priscilla Shulman

• Speech-Language Pathologist in Astoria, NY
• Providers in Astoria, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.