Individual provider Active NPI

Shane Marie Harris, NP

  • Adult Health Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1841518834
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312322 Issued in NY
Practice address
1745 Union Blvd
Bay Shore, NY 11706-7952
Phone
(631) 323-4355
NPI assigned
May 14, 2010
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 652556 NY
Licensed Practical Nurse 164W00000X 291707-1 NY
Adult Health Nurse Practitioner 363LA2200X 312322 NY Primary

Addresses

Primary practice location

1745 Union Blvd
Bay Shore, NY 11706-7952

Mailing address

1745 Union Blvd
Bay Shore, NY 11706-7952
Phone (631) 323-4355

Other practice location 1

14 Bellemeade Ave
Smithtown, NY 11787-1857
Phone (631) 289-0600

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
I20260113001100 NY Practitioner - Nurse Practitioner 9234644352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
652556NYMDRegistered Nurse
291707-1NYMDLicensed Practical Nurse
312322NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 8, 2025 Accepting new patients
New York University CurrentSince Dec 8, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sharris501267@nyumc.direct-ci.com
  • Direct secure messaging: shane.harris.1@20167.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1841518834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-323-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-323-4355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Bellemeade Ave",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117871857",
            "country_code": "US",
            "telephone_number": "631-289-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHANE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "652556",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "291707-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.