David Shack, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307993 Issued in NY

Practice address

75 Maiden LN
Ste 1206
New York, NY 10038-4810

Phone

(212) 995-6495

Fax

(212) 379-6486

NPI assigned

Sep 12, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/77186
• FHIR API: https://fhir4.healow.com/fhir/r4/BHHDBA

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.

• Comprehensive Pain Management and Spine Care, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • New York, NY
  • NPI 1346714664
  NPD (past)
• Comprehensive Pain Management-Anesthesia Services, P.C.

  • Interventional Pain Medicine Physician
  • New York, NY
  • NPI 1174661722
  NPD (past)

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1255889978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MAIDEN LN",
            "address_2": "STE 1206",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384810",
            "telephone_number": "212-995-6495",
            "fax_number": "212-379-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIDEN LN",
            "address_2": "STE 1206",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384810",
            "telephone_number": "212-995-6495",
            "fax_number": "212-379-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACK",
        "first_name": "DAVID",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Mara Shabto, MD
• Uri Shabto, MD
• Marvin Shabus, DDS
• Orna Shachar, DR.
• Susan Eve Shachner, PH.D.
• Annie Cella Shackelford, LCSW
• Michele Dee Shackelford, PH.D.
• Asfa Y Shad, D.O.
• Raquel Shadan
• Shervin Shadianloo, M.D.

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.