Individual provider Active NPI

Ahmed Taha Elsayed Shaaban, MD

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1255191649
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0101285740 Issued in VA
Practice address
1215 Lee St Box 800212
Charlottesville, VA 22908-0816
Phone
(434) 924-2203
Fax
(434) 924-9656
NPI assigned
Mar 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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 0101285740 VA Primary

Addresses

Primary practice location

1215 Lee St Box 800212
Charlottesville, VA 22908-0816

Mailing address

1215 Lee St Box 800212
Charlottesville, VA 22908-0816
Phone (434) 924-2203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240612000461 OH Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5890237341
I20250702002624 VA Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5890237341

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101285740VAMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: ashaaban572830@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1255191649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800212",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2203",
            "fax_number": "434-924-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800212",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2203",
            "fax_number": "434-924-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAABAN",
        "first_name": "AHMED",
        "middle_name": "TAHA ELSAYED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0101285740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.