Shayna Fasanella

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9112616 Issued in FL

Practice address

5540 Pga Blvd Ste 200
Palm Beach Gardens, FL 33418-3987

Phone

(561) 571-4000

Fax

(561) 491-2271

NPI assigned

Jun 14, 2018

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

Other names 1

• Shayna Fasanella Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: sfasanella19759@jupitermedicalcenter.direct-ci.com

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1407349384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 PGA BLVD STE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183987",
            "telephone_number": "561-571-4000",
            "fax_number": "561-491-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 PGA BLVD STE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183987",
            "telephone_number": "561-571-4000",
            "fax_number": "561-491-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANELLA",
        "first_name": "SHAYNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601008742",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9112616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYNA",
            "last_name": "FASANELLA",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Faris K. Azar, M.D., PLLC
• Faro Motta MD PA
• Richard S Faro, M.D.
• Carla Elaine Farrell, CRNA
• Melinda Farrulla
• Ivy Faske, M.D.
• Keaton Fasone
• Emily Morgan Featherstone
• Federal Injury Treatment Center of North Palm Beach
• Michael J Federman, M.D.

• Surgical Physician Assistant in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.