THE SHIELD INSTITUTE
NPI 1184661290
Clinic/Center in Bayside, NY
About The Shield Institute NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE SHIELD INSTITUTE (NPI 1184661290) is a healthcare organization registered as a clinic/center in Bayside, New York and active in the NPI registry since May 2006. The organization maintains 5 additional practice locations and lists Susan Provenzano, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Locations 5
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Shield Institute is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
28Medicare enrollment records show 28 clinicians reassign Medicare billing to The Shield Institute, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 15 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 28Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is The Shield Of David, Inc.'s NPI number?
The NPI number for The Shield Of David, Inc. is 1184661290. It was assigned to this organization in the NPPES registry on May 31, 2006. The provider is doing business as The Shield Institute.
Where is The Shield Of David, Inc. located?
The Shield Of David, Inc. is located at 3909 214th Pl, Bayside, NY 11361. The listed phone number is (718) 269-2004.
What is The Shield Of David, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is The Shield Of David, Inc. enrolled in Medicare?
Yes. The Shield Of David, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through The Shield Of David, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 28 clinicians in 6 Medicare specialties reassign their Medicare billing to The Shield Of David, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (10), Qualified Speech Language Pathologist (9) and Clinical Psychologist (3). Of these, 5 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for The Shield Of David, Inc. was last updated on April 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# The Shield Institute · NPI 1184661290
Clinic/Center organization in Bayside, New York. Organization record, active in the CMS NPPES registry since May 31, 2006.
## Identity
- **NPI:** 1184661290 (Entity type: Organization)
- **Enumerated:** May 31, 2006
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** The Shield Of David, Inc.
- **Organization subpart:** No
- **Authorized official:** Susan Provenzano, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 3909 214TH PL, Bayside, NY 11361-2123
- **Phone:** (718) 269-2004
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 28 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (10), Qualified Speech Language Pathologist (9), Clinical Psychologist (3); 5 practice at this address and 15 within 10 miles; [full list](https://npiprofile.com/npi/1184661290/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 24, 2018
- **Other identifiers:** Medicaid 00243949 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1184661290) · Data from the CMS NPPES public registry.