Individual provider Active NPI

Shelby Katrina Nicosia-Murphy, PA-C

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1033699483
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PA2018-0053 Issued in NM
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-4374
Phone
(505) 272-5551
Fax
(505) 272-6845
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X PA2018-0053 NM
Pediatrics Physician 208000000X PA2018-0053 NM Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-4374

Mailing address

5904 Holly Ave NE
Albuquerque, NM 87113-2472
Phone (505) 298-2505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alishaw@ahpeds.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2018-0053NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Pediatrics PC Pediatrics PastSince Sep 29, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shelby.nicosiamurphy.p13@direct.medcor.nextgenshare.com

Organizations & group practices 1

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1033699483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 HOLLY AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132472",
            "telephone_number": "505-298-2505",
            "fax_number": "505-298-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-5551",
            "fax_number": "505-272-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOSIA-MURPHY",
        "first_name": "SHELBY",
        "middle_name": "KATRINA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NM",
            "license": "PA2018-0053",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "PA2018-0053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alishaw@ahpeds.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5904 Holly Ave NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871132472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.