NPIMap

Individual provider Active NPI

Cassidy Taylor Shoff, CRNA

  • Certified Registered Nurse Anesthetist
  • Hollywood, FL
National Provider Identifier
1376171983
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
006919 Issued in NC
Practice address
421 N 21St Ave
Hollywood, FL 33020-4013
Phone
(814) 319-2484
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 006919 NC Primary

Addresses

Primary practice location

421 N 21St Ave
Hollywood, FL 33020-4013

Mailing address

280 Creekview Dr
Kernersville, NC 27284-6840
Phone (814) 319-2484

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Cassidy.sintobin@mymail.barry.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010003072 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759767007 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Park Hospital LLCGroup PAC ID 4880595958, 109 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-0600

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6919NCMDOccupational Therapy Assistant
006919NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 1, 2022 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1376171983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CREEKVIEW DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272846840",
            "telephone_number": "814-319-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N 21ST AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204013",
            "telephone_number": "814-319-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOFF",
        "first_name": "CASSIDY",
        "middle_name": "TAYLOR",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "006919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cassidy.sintobin@mymail.barry.edu",
            "affiliation": "N",
            "address_1": "421 N 21st Ave",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330204013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.