1. Home
  2. Directory
  3. New York
  4. Mineola
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DR. SHANNON POULOSE MD
NPI 1699414243
Student in an Organized Health Care Education/Training Program in Mineola, NY

Active since June 01, 2022PECOS Enrolled
222 STATION PLZ N STE 509, MINEOLA, NY 11501(516) 663-2381 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Shannon Poulose Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANNON POULOSE MD (NPI 1699414243) is an individual student in an organized health care education/training program in Mineola, New York and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699414243
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. SHANNON POULOSECredential: MD
Location Address222 STATION PLZ N STE 509Mineola, NY 11501-3893
Mailing Address222 Station Plz N Ste 509Mineola, NY 11501-3893 · (516) 663-2381
Phone(516) 663-2381
Sole ProprietorNo
Enumeration DateJune 1, 2022
Last NPPES UpdateApril 30, 2024
NPPES CertifiedJune 1, 2022
✔ NPI 1699414243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
222 STATION PLZ N STE 509, Mineola, NY 11501
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shannon Poulose Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERIK LAWRENCE MD
Radiology (Diagnostic Radiology)
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
YAATHIKA CHALLAPALLI MD
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
BYEONGHO JUNG MD
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
MATTHEW SEIBERT MD
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
DARAN SCHILLER MD
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
BILLY DING
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-2381
ALEXANDER GREENSTONE
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (646) 929-7870
TREVOR JAMES MCHUGH MD
Student in an Organized Health Care Education/Training Program
222 STATION PLZ N STE 509
MINEOLA, NY 11501
Nassau County (516) 663-1500

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 Shannon Poulose's NPI number?

The NPI number for Shannon Poulose is 1699414243. It was assigned to this individual provider in the NPPES registry on June 1, 2022.

Where is Shannon Poulose located?

Shannon Poulose practices at 222 Station Plz N Ste 509, Mineola, NY 11501. The listed phone number is (516) 663-2381.

What is Shannon Poulose's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shannon Poulose enrolled in Medicare?

Yes. Shannon Poulose is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Poulose was last updated on April 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.