NPIMap

Individual provider Active NPI

Shalee Lynn Shumiloff, PA-C

  • Medical Physician Assistant
  • Smithfield, PA
National Provider Identifier
1629021522
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051854 Issued in PA
Practice address
100 Ridgeview Dr
Unit 3
Smithfield, PA 15478-1650
Phone
(724) 569-8100
Fax
(724) 569-8100
NPI assigned
May 19, 2006
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051854 PA Primary

Addresses

Primary practice location

100 Ridgeview Dr
Unit 3
Smithfield, PA 15478-1650

Mailing address

100 Ridgeview Dr
Unit 3
Smithfield, PA 15478-1650
Phone (724) 569-8100

Other identifiers 1

IdentifierTypeStateIssuer
382097YP91OtherPAPTAN

Other names 1

  • Shalee Lynn Nash Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190107003093 WV Practitioner - Physician Assistant 7719934231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

2601 Cranberry SQ
Morgantown, WV 26508-9201
Phone (304) 285-1702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2219WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Apr 17, 2021 Accepting new patients
Emergency Medicine Physicians of Allegheny County LTD Past Accepting new patients
Montgomery Medical, Inc. PastSince Dec 1, 2023 Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

1377 Locust Ave
Fairmont, WV 26554
Phone (304) 363-3500

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

600 Suncrest Town Centre Dr
Ste 310
Morgantown, WV 26505
Phone (304) 598-2200

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1629021522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIDGEVIEW DR",
            "address_2": "UNIT 3",
            "city": "SMITHFIELD",
            "state": "PA",
            "postal_code": "154781650",
            "telephone_number": "724-569-8100",
            "fax_number": "724-569-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIDGEVIEW DR",
            "address_2": "UNIT 3",
            "city": "SMITHFIELD",
            "state": "PA",
            "postal_code": "154781650",
            "telephone_number": "724-569-8100",
            "fax_number": "724-569-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMILOFF",
        "first_name": "SHALEE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "382097YP91",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHALEE",
            "last_name": "NASH",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smithfield, PA

Sources for this page

Verify at the official NPI Registry.