Shadd Nathan Cabalatungan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

70825 Issued in AZ

Practice address

Copper Queen Community Hospital
101 Cole Ave
Bisbee, AZ 85603

Phone

(310) 618-4910

NPI assigned

Apr 4, 2020

Last updated

Sep 5, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

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 2

Specialty

Pediatric Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Specialist Physicians Medical Associates, IncGroup PAC ID 2163329822, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shadd.cabalatungan.1@18129.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Specialist Physicians Medical Associates, Inc

  • Emergency Medicine Physician
  • Torrance, CA
  • NPI 1518917913
  Medicare reassignment Care Compare group NPD
• Benson Hospital Corporation

  • Critical Access Hospital
  • Benson, AZ
  • NPI 1336118322
  Medicare reassignment NPD
• Bisbee Hospital Association

  • Critical Access Hospital
  • Bisbee, AZ
  • NPI 1518968767
  Medicare reassignment NPD
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Ies Arizona PLLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1821752213
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates

  • Emergency Medicine Physician
  • Mission Viejo, CA
  • NPI 1073542916
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment NPD
• Benson Hospital Corporation

  • Rural Health Clinic/Center
  • Vail, AZ
  • NPI 1457924920
  NPD
• Bisbee Hospital Association

  dba Copper Queen Community Hospital Hereford RHC

  • Rural Health Clinic/Center
  • Hereford, AZ
  • NPI 1245986975
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  dba Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1033748777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 N DARTWHITE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857415268",
            "telephone_number": "310-618-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COPPER QUEEN COMMUNITY HOSPITAL",
            "address_2": "101 COLE AVE",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "85603",
            "telephone_number": "310-618-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALATUNGAN",
        "first_name": "SHADD",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "70825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Rose Blunt, LCSW
• Boys & Girls Club of Bisbee,Az,Inc
• Brave Path Counseling PLLC
• Julia M Brown, M.D.
• Ernestina S Buck, PHD
• Phyllis Cavanaugh, D.C.
• Nicole M. Chavez, N.P.
• Chiricahua Community Health Centers, Inc (Chiricahua Community Health Centers, INC-Bisbee Clinic)
• Chiricahua Community Health Centers, Inc (Chiricahua Community Health Centers, Inc - Bisbee)
• Chiricahua Community Health Centers, Inc. (Chiricahua Bisbee Pharmacy)

• Emergency Medicine Physician in Bisbee, AZ
• Providers in Bisbee, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.