Individual provider Active NPI

Pamela L Shuman, MD

  • Child & Adolescent Psychiatry Physician
  • Danielson, CT
National Provider Identifier
1265409031
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
047955 Issued in CT
Practice address
934 N Main St
Danielson, CT 06239-1405
Phone
(860) 779-2101
Fax
(860) 779-3807
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 047955 CT Primary
Child & Adolescent Psychiatry Physician 2084P0804X 9144 RI

Addresses

Primary practice location

934 N Main St
Danielson, CT 06239-1405

Mailing address

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

Other identifiers 1

IdentifierTypeStateIssuer
7005695MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20101028001275 CT Practitioner - Psychiatry 6507050028 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9144RIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windham Community Memorial Hospital, Inc. CurrentSince Dec 10, 2018 Accepting new patients
Natchaug Hospital, Inc. CurrentSince Dec 16, 2018 Accepting new patients

Locations

934 N Main St
Danielson, CT 06239
Phone (860) 779-2101

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: pamela.shuman@xdr.hhchealthdirect.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1265409031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683",
            "telephone_number": "860-456-1311",
            "fax_number": "860-423-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 N MAIN ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062391405",
            "telephone_number": "860-779-2101",
            "fax_number": "860-779-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "PAMELA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "047955",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "9144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005695",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.