Active NPI
Tyler Shenk-Foley, PA-C
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1962789032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 015281-1
- Practice address
- 150 55TH St
Brooklyn, NY 11220-2553 - Phone
- (718) 630-8718
- NPI assigned
- Nov 3, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015281-1 | NY | Primary |
Addresses
Primary practice location
150 55TH St
Brooklyn, NY 11220-2553
Mailing address
698 4TH Ave
Apt 2
Brooklyn, NY 11232-1237
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015281-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1962789032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "698 4TH AVE",
"address_2": "APT 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112321237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 55TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112202553",
"telephone_number": "718-630-8718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENK-FOLEY",
"first_name": "TYLER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-03",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "015281-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.