Ibrahim Atanda Shode

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

113637-23 Issued in NH

Practice address

57 Villa Ave
North Providence, RI 02904-4421

Phone

(401) 663-8893

NPI assigned

Dec 6, 2024

Sex

Male

Sole proprietor

Yes

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 NH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Medicine Physicians of New York - Patchogue PCGroup PAC ID 6406183821, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern NH Medical Center Hospital, Nashua, NH, CCN 300020

Medicare enrollment (NPD)

Enrolled

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.

• Hospitalist Medicine Physicians of New York - Patchogue PC

  • Anesthesiology Physician
  • Patchogue, NY
  • NPI 1366920993

  NH, Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Southern NH Medical Center

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1245447994
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1497561203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 VILLA AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044421",
            "telephone_number": "401-663-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 VILLA AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044421",
            "telephone_number": "401-663-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHODE",
        "first_name": "IBRAHIM",
        "middle_name": "ATANDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "113637-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy G Serabian, R.N. C.S.
• Serene Horizons Therapy LLC
• Abdol Hamid Shahinfar, MD
• Rebecca Shannon Hernandez
• Shaws Supermarkets Inc
• Roshani Shrestha, FNP
• Courtney Elizabeth Silva
• Silver Fern Practice, LLC
• Steven Wayne Silverberg, DMD
• Kevin Silvestre, PHARMD

• Certified Registered Nurse Anesthetist in North Providence, RI
• Providers in North Providence, RI by specialty
• Certified Registered Nurse Anesthetist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.