Shira Tannenbaum

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DO-04709 Issued in IA

Practice address

1227 E Rusholme St
Davenport, IA 52803-2459

Phone

(563) 324-8160

Fax

(563) 324-8486

NPI assigned

May 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Anesthesiology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia and Analgesia PCGroup PAC ID 7810887627, 22 clinicians

Mercy Clinton Anesthesia Group, LLCGroup PAC ID 9537306394, 8 clinicians

Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080
• Mercyone Dubuque Medical Center Hospital, Dubuque, IA, CCN 160069
• Mercyone Genesis Dewitt Medical Center Hospital, Dewitt, IA, CCN 161313

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shira.black@direct.genesishealth.com

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.

• Anesthesia & Analgesia PC

  • Anesthesiology Physician
  • Davenport, IA
  • NPI 1558306381
  Medicare reassignment Care Compare group NPD
• Medical Associates Clinic P C

  • Multi-Specialty Clinic/Center
  • Dubuque, IA
  • NPI 1457300790
  Medicare reassignment Care Compare group NPD
• Mercy Clinton Anesthesia Group LLC

  • Anesthesiology Physician
  • Clinton, IA
  • NPI 1184962862
  Medicare reassignment Care Compare group NPD
• Dubuque Anesthesia Services, PC

  • Certified Registered Nurse Anesthetist
  • Dubuque, IA
  • NPI 1356455257
  NPD (past)
• The Pain Relief Clinic, P.C.

  • Pain Clinic/Center
  • Davenport, IA
  • NPI 1316286677
  NPD (past)

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

• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation
• Mercy Medical Center-Clinton, Inc

  • General Acute Care Hospital
  • Clinton, IA
  • NPI 1427093962
  Care Compare affiliation
• Mercy Medical Center-Dubuque

  • General Acute Care Hospital
  • Dubuque, IA
  • NPI 1659348506
  Care Compare affiliation

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1336467489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527220021",
            "telephone_number": "563-324-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-324-8160",
            "fax_number": "563-324-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "SHIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IA",
            "license": "DO-04709",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "DO-04709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shira.black@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 E Rusholme St",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Traci Anne Swift
• Richard L Syfert, DO
• Alexandra Symans, DMD
• Bernard P Tadda, FNP
• Anne Taets, LMHC
• Susan Elizabeth Tapia, LMHC
• Robert C Tatum, DC, DACBR
• Jacob Tauke, RPH
• Mary-Anne Tawiah-Boateng, PHARMD
• Marjorie Taylor, DDS

• Anesthesiology Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Anesthesiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.