Individual provider Active NPI

Deborah Valentine Shamsian, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1003260241
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
299339-01 Issued in NY
Practice address
21 W 86TH St
New York, NY 10024-3671
Phone
(212) 304-5800
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 299339-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

21 W 86TH St
New York, NY 10024-3671

Mailing address

505 S Main St
Suite 525
Orange, CA 92868-4509
Phone (714) 456-5631

Other practice location 1

505 S Main St
Suite 525
Orange, CA 92868-4509
Phone (714) 456-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618001287 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6406101385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
299339-01NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Past Accepting new patients
Rebecca Di Mundo, M.D., Inc Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1003260241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "address_2": "SUITE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684509",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243671",
            "telephone_number": "212-304-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St",
            "address_2": "Suite 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684509",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMSIAN",
        "first_name": "DEBORAH",
        "middle_name": "VALENTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "299339-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.