NPIMap

Individual provider Active NPI

Nancy Ann Shaheen, MD

  • Diagnostic Radiology Physician
  • New Hartford, NY
National Provider Identifier
1194781658
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
209580 Issued in NY
Practice address
1656 Champlin Ave
New Hartford, NY 13413
Phone
(315) 624-6116
Fax
(315) 624-6318
NPI assigned
Apr 25, 2006
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 209580 NY Primary

Addresses

Primary practice location

1656 Champlin Ave
New Hartford, NY 13413

Mailing address

185 Genesee St
Suite 600
Utica, NY 13501-2102

Other identifiers 9

IdentifierTypeStateIssuer
040426014048OtherNYFIDELIS
01885469MedicaidNY
01647929MedicaidNY
10047014OtherNYCDPHP
209580-1OtherNYWC
41996114OtherNYGHI
300085250OtherNYRAIL ROAD MEDICARE
9607833OtherNYMVP
P010209580OtherNYBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040527000593 NY Practitioner - Diagnostic Radiology 1951382779 Reassigns benefits to 2 organizations
I20230222002235 FL Practitioner - Diagnostic Radiology 1951382779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cmi Professional ServicesGroup PAC ID 2466419718, 13 clinicians
Radiology Associates of New Hartford LLPGroup PAC ID 6002807831, 21 clinicians

Practice addresses (Care Compare)

107 Business Park Dr
Utica, NY 13502-6303
Phone (315) 792-4666

1656 Champlin Ave
Utica, NY 13502-4830
Phone (315) 646-6116

610 Rudder Rd
Naples, FL 34102-5041
Phone (800) 889-8610

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of New Hartford LLP Diagnostic Radiology CurrentSince Jul 1, 1998 Accepting new patients
Cmi Professional Services CurrentSince Nov 1, 2001 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1729 Burrstone Rd
New Hartford, NY 13413
Phone (315) 798-1500

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

107 Business Park Dr
Utica, NY 13502
Phone (315) 792-4666

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

185 Genesee St
Ste 600
Utica, NY 13501
Phone (315) 793-5506

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1194781658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 GENESEE ST",
            "address_2": "SUITE 600",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "13413",
            "telephone_number": "315-624-6116",
            "fax_number": "315-624-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "209580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426014048",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01885469",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01647929",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10047014",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "209580-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "41996114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "300085250",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "9607833",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P010209580",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.