Shanmukha Priya, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

265894 Issued in NY

Practice address

20B Meacham Ave
Elmont, NY 11003-2654

Phone

(516) 270-2569

Fax

(516) 706-6026

NPI assigned

Dec 7, 2011

Last updated

Apr 2, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• True North Medical Group, LLC

  dba True North Pediatrics

  • Pediatrics Physician
  • Willow Grove, PA
  • NPI 1750929907
  NPD (past)

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1992073787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 SUN AVENUE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032640",
            "telephone_number": "718-210-8378",
            "fax_number": "888-858-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20B MEACHAM AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032654",
            "telephone_number": "516-270-2569",
            "fax_number": "516-706-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIYA",
        "first_name": "SHANMUKHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "265894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious Care Homes LLC
• Dawn Precious Paul Baptiste
• Precious Wholeness LCSW PLLC
• Premium Smiles LLC
• Tiffany Yolanda Priester, NP
• Kerwayne H Probherbs, M.D.
• Professional Balance Physical Therapy, PLLC
• Tanya Pruden
• Myriam Prudhomme
• Patricia Pryce

• Pediatrics Physician in Elmont, NY
• Providers in Elmont, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.