Shane Henry Duda, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.004537 Issued in OH

Practice address

627 Eastland Ave SE Ste 102
Warren, OH 44484-4501

Phone

(330) 306-5030

NPI assigned

Oct 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.99 of 100Reported as group

Quality

97.69

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.8 of 100Reported as group

Quality

79.54

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

89.13 of 100Reported as group

Quality

78.7

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.13 of 100Reported as group

Quality

79.67

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sduda204492@direct.bsmhealth.org

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.

• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  OH

  Medicare reassignment Care Compare group
• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment
• Mahoning Valley Emergency Specialists LLC

  • Emergency Medicine Physician
  • Youngstown, OH
  • NPI 1003869652
  Medicare reassignment
• Mves Austintown LLC

  • Emergency Medicine Physician
  • Austintown, OH
  • NPI 1972555944
  Medicare reassignment
• Mves Boardman LLC

  • Emergency Medicine Physician
  • Youngstown, OH
  • NPI 1205888237
  Medicare reassignment
• Ahn Emergency Group of Lawrence County LTD.

  • Emergency Medicine Physician
  • New Castle, PA
  • NPI 1871918235
  NPD (past)

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1609248046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 EASTLAND AVE SE STE 102",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844501",
            "telephone_number": "330-306-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 EASTLAND AVE SE STE 102",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844501",
            "telephone_number": "330-306-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDA",
        "first_name": "SHANE",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057965",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Draper
• Drayer Physical Therapy Institute LLC
• Dreamu, LLC
• Christy Drummond, MSN, PMHNP-BC
• Duck Inpatient Services, LLC
• Stephanie Duda
• Melissa Dugan, RN
• Adell Dukes
• Lori Ann Dukes
• Shira Shawnta Dukes

• Medical Physician Assistant in Warren, OH
• Providers in Warren, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.