Deepak Kumar Shan, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD496655 Issued in PA

Practice address

2315 Myrtle St Ste 120
Erie, PA 16502-4602

Phone

(814) 456-9197

Fax

(814) 455-2765

NPI assigned

Apr 10, 2021

Last updated

Sep 28, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Vincent Consultants in Cardiovascular Diseases

  • Cardiovascular Disease Physician
  • Erie, PA
  • NPI 1902114911
  NPD (past)
• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477
  NPD (past)

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1356921704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 SASSAFRAS ST STE 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022721",
            "telephone_number": "412-325-5808",
            "fax_number": "814-452-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 120",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024602",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124772",
            "country_code": "US",
            "telephone_number": "412-359-3836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAN",
        "first_name": "DEEPAK",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD496655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asif Shakoor
• Sohale Abraham Shakoor, DO
• Purnima Shakya, MD
• Florence Helen Shallenberger, LPN
• Shamoy Real Estate, LLC (Live Alive Personal Care Homes & Home Services)
• Bridget Shanahan
• Joshua Shanahan
• Lindsay Anne Shankman, DO
• Shaping Successful Futures Counseling
• Jeremy R Shapiro, DO

• Vascular Surgery Physician in Erie, PA
• Providers in Erie, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.