Shailendra Misra, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.091910 Issued in OH

Practice address

725 S Shoop Ave
Wauseon, OH 43567-1702

Phone

(419) 335-3333

Fax

(419) 337-7845

NPI assigned

Oct 17, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shailendra.misra@fultoncounty.medicity.net

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.

• FCHC Medical Care, LLC

  • Multi-Specialty Clinic/Center
  • Wauseon, OH
  • NPI 1598821175
  NPD (past)
• Fulton County Health Center

  • Critical Access Hospital
  • Wauseon, OH
  • NPI 1548279714
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1508055468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-335-3333",
            "fax_number": "419-337-7845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISRA",
        "first_name": "SHAILENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.091910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Mielke
• Miller'S Hvacr Services, LLC
• Mind Redo
• Estela Miquiabas, MD
• Miquiabas, Inc.
• Masedonio Molina
• Janis L Mondelli, RPH
• Cassandra Michelle Montes
• Monti Behavioral LLC
• Morenci Medical Assoc, PC

• Pediatrics Physician in Wauseon, OH
• Providers in Wauseon, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.