Elaine Shan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A168601 Issued in CA

Practice address

3234 Marysville Blvd
Sacramento, CA 95815-1411

Phone

(918) 407-2495

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eshan343268@direct.ochin.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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853
  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1205341336
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1053767434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 455",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251086",
            "telephone_number": "918-407-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151411",
            "telephone_number": "918-407-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave Rm 3301",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857240001",
            "country_code": "US",
            "telephone_number": "520-626-7944",
            "fax_number": "520-626-5652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Calle Portal Ste 700",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "85635",
            "country_code": "US",
            "telephone_number": "520-459-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAN",
        "first_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "58623",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R75544",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A168601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Shamrina
• Hazem N Shamseddeen, M.D.
• Dalia Shamsian, PA-C
• Shamynds Healing Center PC
• Shamynds TMS Brain-Stim
• Karen Shanahan, RADT1
• Jaclyn Ann Shandy, M.A., BCBA
• Lily Shane
• William Martin Shaner, MHRS
• Ellen Shank, MD

• Pediatrics Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.