Individual provider Active NPI

Amr A Shahin, MBBCH, FAAP

  • Pediatric Critical Care Medicine Physician
  • Naples, FL
National Provider Identifier
1407960156
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME170470 Issued in FL
Practice address
11190 Health Park Blvd
Naples, FL 34110-5729
Phone
(239) 624-5322
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 56753 AZ
Pediatric Critical Care Medicine Physician 2080P0203X ME170470 FL Primary

Addresses

Primary practice location

11190 Health Park Blvd
Naples, FL 34110-5729

Mailing address

11190 Health Park Blvd
Naples, FL 34110-5729

Other identifiers 1

IdentifierTypeStateIssuer
426671MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56753AZMDPediatric Critical Care Medicine Physician
ME170470FLMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Aug 30, 2018 Accepting new patients
Wesley Medical Center LLC Past Accepting new patients

Locations

4881 E Grant Rd
Ste 201
Tucson, AZ 85712
Phone (520) 324-2414

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1407960156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105729",
            "telephone_number": "239-624-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIN",
        "first_name": "AMR",
        "middle_name": "A",
        "credential": "MBBCH, FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "56753",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME170470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426671",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.