Lyea Dorae Shine

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

811313 Issued in NY

Practice address

502 McCurry St
Pleasant Hope, MO 65725-9231

Phone

(904) 254-3686

NPI assigned

Nov 3, 2020

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 NY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agcny Physicians PLLCGroup PAC ID 4284804345, 36 clinicians

Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score

98.09 of 100Reported as group

Quality

97.07

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Agcny Physicians PLLC

  • Anesthesiology Physician
  • Fayetteville, NY
  • NPI 1033497136
  Medicare reassignment Care Compare group NPD
• Chag Anesthesia PC

  • Anesthesiology Physician
  • Syracuse, NY
  • NPI 1740279017
  Medicare reassignment Care Compare group NPD
• Syracuse Gastroenterological Associates.PC

  • Gastroenterology Physician
  • East Syracuse, NY
  • NPI 1619947843
  Medicare reassignment NPD
• North American Partners in Anesthesia LLP

  • Anesthesiology Physician
  • Melville, NY
  • NPI 1649264706
  NPD
• Syracuse Gastroenterological Associates PC

  • Anesthesiology Physician
  • East Syracuse, NY
  • NPI 1417326661
  NPD

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

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1396346870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130660068",
            "telephone_number": "904-254-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MCCURRY ST",
            "city": "PLEASANT HOPE",
            "state": "MO",
            "postal_code": "657259231",
            "telephone_number": "904-254-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "LYEA",
        "middle_name": "DORAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2014029095",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "811313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Citrix",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Health Information Lookup",
            "address_1": "502 McCurry St",
            "city": "Pleasant Hope",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657259231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colby Grove, PHARMD
• Jeanne E Hermann
• Rahela Lup
• Next Chapter Counseling
• Pleasant Hope School Dist R6
• The Pharmacy I LLC

• Certified Registered Nurse Anesthetist in Pleasant Hope, MO
• Providers in Pleasant Hope, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.