Individual provider Active NPI

Shannon Maloney, D.P.M

  • Foot Surgery Podiatrist
  • Islip, NY
National Provider Identifier
1750577276
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
006240-1 Issued in NY
Practice address
118 Elder Rd
Islip, NY 11751-4911
Phone
(917) 670-9166
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 006240-1 NY Primary

Addresses

Primary practice location

118 Elder Rd
Islip, NY 11751-4911

Mailing address

652 Suffolk Ave
Suite 204
Brentwood, NY 11717-4391
Phone (631) 231-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006240-1NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Foot & Ankle Specialist DPM PC Foot Surgery CurrentSince May 18, 2008 Accepting new patients
Prohealth Care Associates LLP PastSince May 18, 2008 Accepting new patients

Locations

652 Suffolk Ave
Ste 204
Brentwood, NY 11717
Phone (631) 231-1401

Organizations & group practices 2

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1750577276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 SUFFOLK AVE",
            "address_2": "SUITE 204",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174391",
            "telephone_number": "631-231-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 ELDER RD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117514911",
            "telephone_number": "917-670-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "006240-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.