Devan Alexander Shambo, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

045562 Issued in NY

Practice address

310 Taughannock Blvd
Ithaca, NY 14850-3251

Phone

(607) 277-3861

NPI assigned

Feb 20, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cayuga Medical Center

  • Rural Acute Care Hospital
  • Ithaca, NY
  • NPI 1477877876
  NPD (past)
• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1164547303
  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1609409358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 UPTOWN RD APT 31",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501602",
            "telephone_number": "845-633-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503251",
            "telephone_number": "607-277-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBO",
        "first_name": "DEVAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "045562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshambo@cayugamed.org",
            "affiliation": "N",
            "endpointDescription": "personal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "med communication",
            "address_1": "310 Taughannock Blvd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148503251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mohammad Ali Shahab, MBBS
• Hamid Saeed Shaikh
• Shakespeare & Muscente LCSW, PLLC
• Leslie Shakespeare, LCSW
• Neil Frederick Shallish, M.D.
• Catherine Shane
• Xue-Cheng Shang
• Rachael Shapiro, MSW
• Tammy Louise Bennington Shapiro, LCSW, PH.D.
• Andrea Beth Sharkness

• Orthopedic Physical Therapist in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Orthopedic Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.