Individual provider Active NPI

Sana Jahan Shamim, D.P.M

  • Podiatrist
  • Frederick, MD
National Provider Identifier
1619317419
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01600 Issued in MD
Practice address
63 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4384
Phone
(301) 696-0818
NPI assigned
Jun 26, 2013
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01600 MD Primary

Addresses

Primary practice location

63 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4384

Mailing address

63 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4384
Phone (301) 696-0818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011001008 MD Practitioner - Podiatry 0042508814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

63 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4396
Phone (301) 696-0818

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of nail tissue919
Removal or shaving of skin growth108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Aug 15, 2016 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Aug 15, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

63 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 696-0600

8028 Ritchie Hwy
Ste 100
Pasadena, MD 21122
Phone (410) 356-9939

Interoperability endpoints

  • Direct secure messaging: sshamim@usfas.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1619317419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR",
            "address_2": "SUITE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024384",
            "telephone_number": "301-696-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR",
            "address_2": "SUITE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024384",
            "telephone_number": "301-696-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMIM",
        "first_name": "SANA",
        "middle_name": "JAHAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.