Shahana Lee Theriault, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3231 Issued in CT

Practice address

2416 Whitney Ave FL 1
Hamden, CT 06518-3248

Phone

(203) 407-3550

Fax

(203) 407-4244

NPI assigned

Nov 4, 2014

Sex

Female

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 CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Orthopaedic Specialists PCGroup PAC ID 7315850039, 184 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.81 of 100Reported as group

Quality

79.31

Promoting interoperability

100

Improvement activities

40

Cost

80.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stheriault130897@direct.ynhh.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.

• Connecticut Orthopaedic Specialists, PC

  • Orthopaedic Surgery Physician
  • Hamden, CT
  • NPI 1235181389
  Medicare reassignment Care Compare group
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1114322153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183209",
            "telephone_number": "203-626-0160",
            "fax_number": "203-294-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 WHITNEY AVE FL 1",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183248",
            "telephone_number": "203-407-3550",
            "fax_number": "203-407-4244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Bridgeport Ave",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064843861",
            "country_code": "US",
            "telephone_number": "203-538-0020",
            "fax_number": "203-538-0023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 Boston Post Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773229",
            "country_code": "US",
            "telephone_number": "203-795-4784",
            "fax_number": "203-799-1179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "SHAHANA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Children'S Center of Hamden, Inc.
• The Connecticut Center for Facial Plastic
• The Lasik Vision Institute LLC
• The Orthopaedic Group, LLC
• Therapeia Lymphedema Center, LLC
• Theric Corporation
• Stefanie Theroux, LCSW
• Prem George Thomas, MD
• Andrew Wayne Thompson
• Jennifer Su Thompson, MD

• Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.