Shelby Danielle Alexa-Dizard, CNM/WHNP, RN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

421498 Issued in NY

Practice address

136 Lake St Ste 11
Newburgh, NY 12550-5245

Phone

(845) 562-7800

NPI assigned

Jun 5, 2019

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Shelby Danielle Alexa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Registered Nurse

State licenses

Practice roles

Locations

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.

• Laboratory Medicine Associates, LLP

  • Anatomic Pathology & Clinical Pathology Physician
  • Nyack, NY
  • NPI 1740251578
  NPD
• Montefiore Nyack Hospital

  • Neurology Physician
  • Nyack, NY
  • NPI 1073881835
  NPD
• Montefiore Nyack Hospital

  • General Acute Care Hospital
  • Nyack, NY
  • NPI 1104808062
  NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  NPD
• Planned Parenthood of Greater New York Inc

  • Ambulatory Family Planning Facility
  • Brooklyn, NY
  • NPI 1417959701
  NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• Planned Parenthood of the Southern Finger Lakes Inc.

  • Ambulatory Family Planning Facility
  • Ithaca, NY
  • NPI 1881761484
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1770141616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 SHERIDAN RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831553",
            "telephone_number": "734-972-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 LAKE ST STE 11",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505245",
            "telephone_number": "845-562-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXA-DIZARD",
        "first_name": "SHELBY",
        "middle_name": "DANIELLE",
        "credential": "CNM/WHNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421498",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "685729",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001920",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WHNP LICENSE",
            "identifier": "421498",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM",
            "identifier": "001920",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "ALEXA",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Alarcon
• Emma Albarino, M.S.
• Albert P Hirdt DO PC
• Ryan Albertson
• Martina Victoria Albulet, RN
• Leah Francis Alexander-Cormier
• Rebecca Stella Alexander, DPT
• Judine Alexandre, COTA/L
• Ashley Elizabeth Alfano, RN, BSN
• Michael Alicea

• Women's Health Nurse Practitioner in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Women's Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.