Individual provider Active NPI

Danielle Lauren Shore

  • Anesthesiology Physician
  • New Haven, CT
National Provider Identifier
1457976151
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME166898 Issued in FL
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-9503
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT221156 PA
Student in an Organized Health Care Education/Training Program 390200000X 68464 CT
Anesthesiology Physician 207L00000X ME166898 FL Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 688-9503

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404000383 FL Practitioner - Anesthesiology 4789086992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Florida State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boca Anesthesia Service IncGroup PAC ID 8325016975, 65 clinicians

Practice addresses (Care Compare)

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (954) 939-5000

Hospital & facility affiliations

  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT221156PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boca Anesthesia Service Inc Anesthesiology CurrentSince Feb 21, 2024 Accepting new patients
Boca Anesthesia Service Inc Anesthesiology Current Accepting new patients

Locations

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

1905 Clint Moore Rd
Ste 115
Boca Raton, FL 33496
Phone (561) 509-5084

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.

Hospital & facility affiliations 1

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1457976151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-9503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "DANIELLE",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT221156",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "68464",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME166898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.