Hassan Shahbandar, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

18921 Issued in WI

Practice address

900 E Grant St
E110
Appleton, WI 54911-3487

Phone

(920) 729-7105

Fax

(920) 739-2609

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Theda Clark OB Hospitalists SC

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1295510196
  NPD (past)
• Women's Health Specialists, S.C.

  • Obstetrics & Gynecology Physician
  • Appleton, WI
  • NPI 1417086216
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1467581223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 W PROSPECT AVE",
            "address_2": "SUITE LL1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148798",
            "telephone_number": "920-729-7105",
            "fax_number": "920-831-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E GRANT ST",
            "address_2": "E110",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113487",
            "telephone_number": "920-729-7105",
            "fax_number": "920-739-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBANDAR",
        "first_name": "HASSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WI",
            "license": "18921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31146500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pablo E Serna
• Amy H Servais, MD
• Angela M. Servin, CRNA
• Amy Sexton
• Lauryn B Sexton, CD
• Danielle L Shannon, RDH
• Marc Shantz
• Brittany K Shaw, CD
• Heather Denise Shaw
• Carolyn Shea

• Gynecology Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.