Individual provider Active NPI

Paul C Shakin, M.D.

  • Anesthesiology Physician
  • Mechanicsville, VA
National Provider Identifier
1477541878
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101055829 Issued in VA
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 288-6258
Fax
(804) 282-9921
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101055829 VA Primary

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

5855 Bremo Rd
Suite 100 North
Richmond, VA 23226-1926
Phone (804) 288-6258

Other identifiers 1

IdentifierTypeStateIssuer
5721059MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040816001227 VA Practitioner - Anesthesiology 7012980295 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101055829VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia PC Anesthesiology Current Accepting new patients
American Anesthesiology of Virginia, PC Anesthesiology CurrentSince Jan 19, 2016 Accepting new patients
MCV Associated Physicians Anesthesiology PastSince Sep 28, 2021 Accepting new patients

Locations

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

5855 Bremo Rd
Ste 100
Richmond, VA 23226
Phone (804) 288-6258

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 3

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1477541878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD",
            "address_2": "SUITE 100 NORTH",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261926",
            "telephone_number": "804-288-6258",
            "fax_number": "804-282-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-288-6258",
            "fax_number": "804-282-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIN",
        "first_name": "PAUL",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101055829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5721059",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.