Suzanne M Shimaitis, P.A.C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-002827 Issued in IL

Practice address

702 S Cumberland St
Lebanon, TN 37087-4110

Phone

(615) 444-2121

Fax

(615) 547-6474

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

No

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 TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anycare LLCGroup PAC ID 0244463529, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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.

• Anycare LLC

  • Urgent Care Clinic/Center
  • Lebanon, TN
  • NPI 1780022855
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1285718874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S CUMBERLAND ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874110",
            "telephone_number": "615-444-2121",
            "fax_number": "615-547-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S CUMBERLAND ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874110",
            "telephone_number": "615-444-2121",
            "fax_number": "615-547-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMAITIS",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Shehab Sedhom, MD
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• Serenity Dental
• Grant Shanks, PT
• Xin Shen
• Kerri Shingleton, MS, RD, LDN, CNSC
• Kristen Brooke Shores, MS,CCC-SLP
• Simply Elite in Home Care, LLC
• Ashlen Skelton, DC
• Raymond Michael Slifka, DPT

• Physician Assistant in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.