Individual provider Active NPI

Shaun Michael Pateman Aciu, MD

  • Student in an Organized Health Care Education/Training Program
  • Allentown, PA
National Provider Identifier
1114661964
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
MT225292 Issued in PA
Practice address
2490 Schoenersville Rd
Allentown, PA 18109-9501
Phone
(484) 526-7262
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT225292 PA Primary

Addresses

Primary practice location

2490 Schoenersville Rd
Allentown, PA 18109-9501

Mailing address

1019 Delaware Ave
Fountain Hill, PA 18015-2508

Other names 1

  • Shaun Michael Pateman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20220609002880 PA Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 5991183550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT225292PAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1114661964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 DELAWARE AVE",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180152508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 SCHOENERSVILLE RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099501",
            "telephone_number": "484-526-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEMAN ACIU",
        "first_name": "SHAUN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT225292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUN",
            "last_name": "PATEMAN",
            "middle_name": "MICHAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.