Shijun Pan, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME99122 Issued in FL

Practice address

535 S Ferdon Blvd Ste C
Crestview, FL 32536-4446

Phone

(850) 423-4664

Fax

(850) 398-8824

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

Yes

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 FL

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

Specialty

Neurology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Crestview Neurology

  • Neurology Physician
  • Crestview, FL
  • NPI 1194911768
  Medicare reassignment NPD Authorized official

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

• Crestview Hospital Company, LLC

  dba North Okaloosa Medical Center

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1245280858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S FERDON BLVD STE C",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364446",
            "telephone_number": "850-423-4664",
            "fax_number": "850-398-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S FERDON BLVD STE C",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364446",
            "telephone_number": "850-423-4664",
            "fax_number": "850-398-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "SHIJUN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME99122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Marie Padilla
• Rosaura Cristina Pagan, RBT
• Kristin Page, LMHC
• Christina Palmer
• Pamela Pierce LLC
• Panhandle Diagnostics LLC (Panhandle Diagnostics)
• Panhandle Orthopaedics LLC
• Panhandle Sleep Dentistry LLC
• Panhandle Surgical Institute LLC
• Ronda Lee Panucci, LMT

• Specialist in Crestview, FL
• Providers in Crestview, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.