Kelly Ann Shine, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

D0060209 Issued in MD

Practice address

74 Thomas Johnson Dr
Frederick, MD 21702-4300

Phone

(301) 694-3200

Fax

(301) 662-5288

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

General Surgery

Education

Yale University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Affiliates of Cape Cod IncGroup PAC ID 3577471564, 237 clinicians

Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna of Cape Cod Home health agency, South Dennis, MA, CCN 227067
• Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012

Merit-based Incentive Payment System (MIPS)

Final score

76.23 of 100Reported as group

Quality

56.78

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.3 of 100Reported as group

Quality

71.45

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Medical Affiliates of Cape Cod, Inc.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1770534927

  Surgery

  Medicare reassignment Care Compare group NPD
• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364
  Medicare reassignment Care Compare group NPD
• Medical Affiliates of Cape Cod, Inc.

  • Ambulatory Surgical Clinic/Center
  • Mashpee, MA
  • NPI 1306391206
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  NPD (past)

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

• Visiting Nurse Association of Cape Cod, Inc.

  • Home Health Agency
  • South Dennis, MA
  • NPI 1649258278
  Care Compare affiliation Name & address match
• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1477522472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E THIRTEENTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014402",
            "telephone_number": "240-285-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024300",
            "telephone_number": "301-694-3200",
            "fax_number": "301-662-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0060209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Paige Shevitz, LMSW
• Tim Zhanxiang Shi, MD, PHD
• James Shifflett
• Shiloh Healthcare LLC
• Shim Wellness
• Julia Shirima, REGISTERD NURSE
• Sarah S Shobert, OTR
• Megan Shockey-Miller
• Te'Andra Shockley, LCSW-C
• Caitlin Erin Shoemaker, L.AC., M.AC.

• Surgery Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.