George Daniel Shanahan IV, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

GDS001605 Issued in MI

Practice address

9640 Commerce Rd Ste 102
Commerce TWP, MI 48382-4167

Phone

(248) 360-3888

Fax

(248) 363-0894

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

G. Daniel Shanahan IV DPM PCGroup PAC ID 2961306105, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gshanaha@direct.dmc.org

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.

• G. Daniel Shanahan IV DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Commerce TWP, MI
  • NPI 1053417816

  Foot & Ankle Surgery, MI

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1003818907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 COMMERCE RD STE 102",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483824167",
            "telephone_number": "248-360-3888",
            "fax_number": "248-363-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 COMMERCE RD STE 102",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483824167",
            "telephone_number": "248-360-3888",
            "fax_number": "248-363-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "GEORGE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "GDS001605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "38-3128264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "130147",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "GDS001605",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5631126",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "U43179",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297370213",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME ADMINISTAR FEDERAL",
            "identifier": "4778520001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bashar Essam Sedki, DDS
• Sarah Melissa Seiderman
• Semma Podiatry PC
• Randy Semma, DPM
• Michael Steven Sesi, DDS
• Edward Shapiro, DDS
• Nicole Marie Sharp, LPTA
• Tara Shefferly
• Noelle Katalin Shender, PAC
• Shoppers Pharmacy LLC

• Foot & Ankle Surgery Podiatrist in Commerce TWP, MI
• Providers in Commerce TWP, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.