Shu Dong, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

20192 Issued in CA

Practice address

12359 Malki Rd
Banning, CA 92220-6974

Phone

(951) 922-2058

Fax

(888) 551-2116

NPI assigned

Mar 21, 2011

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

Medicare fee-for-service enrollment

Enrolled in CA, FL, TX, NY, PA, MA6 enrollments

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 6

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• Careathome Medical Practice (Ma), P.C.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1477123321
  Medicare reassignment NPD
• Careathome Medical Practice Ky

  • Family Medicine Physician
  • New York, NY
  • NPI 1467040345

  Nurse Practitioner, TX

  Medicare reassignment NPD
• Caringathome, LLC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1912595828

  Nurse Practitioner

  Medicare reassignment NPD
• Five Star Medical Office PC

  • Internal Medicine Physician
  • Forest Hills, NY
  • NPI 1760731459
  Medicare reassignment NPD
• Perfect Health PC

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1861815300
  Medicare reassignment NPD
• Physician Services Group of Florida, LLC

  • Family Medicine Physician
  • Gulf Breeze, FL
  • NPI 1235775396
  Medicare reassignment NPD
• Urban Family Practice PC

  • In Home Supportive Care Agency
  • Baltimore, MD
  • NPI 1164594099

  Nurse Practitioner, NY

  Medicare reassignment NPD
• First Americans Medical Group, Inc.

  • Family Medicine Physician
  • Banning, CA
  • NPI 1376185843
  NPD
• Careathome Medical Practice

  • Internal Medicine Physician
  • New York, NY
  • NPI 1891319810

  Family

  NPD
• Psgfl MSSP, LLC

  • Multi-Specialty Clinic/Center
  • Gulf Breeze, FL
  • NPI 1689557936
  NPD (past)

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1376842005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 MALKI RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206974",
            "telephone_number": "951-922-2058",
            "fax_number": "888-551-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 MALKI RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206974",
            "telephone_number": "951-922-2058",
            "fax_number": "888-551-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONG",
        "first_name": "SHU",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1117425",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "20192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle L Dippolito, LPCC
• Scott Ditch
• Neal Dixon, PA
• Leah D. Dixson, PA-C
• Susan H Doddridge, P.A-C
• Lynn Marie Dorrough, CAMTC #527
• Sharlene Ann Dorsey, LCSW
• Dr Shanna R Newbold M D Inc
• Dr. Ohannessian Dental Corp
• Rocio G Drye, LCSW

• Nurse Practitioner in Banning, CA
• Providers in Banning, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.