Individual provider Active NPI

Shasling Delgado-Cordero, PA

  • Physician Assistant
  • Miamisburg, OH
National Provider Identifier
1649722786
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004803 Issued in OH
Practice address
4000 Miamisburg Centerville Rd Ste 100
Miamisburg, OH 45342-7615
Phone
(937) 866-0637
Fax
(937) 866-6713
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004803 OH Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd Ste 100
Miamisburg, OH 45342-7615

Mailing address

4000 Miamisburg Centerville Rd Ste 100
Miamisburg, OH 45342-7615
Phone (937) 866-0637

Other identifiers 1

IdentifierTypeStateIssuer
0209840MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sdelgadocordero569686@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170222001211 OH Practitioner - Physician Assistant 4183908965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

1745 E Stroop Rd
Kettering, OH 45429-5039
Phone (937) 381-6340

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.004803OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince May 1, 2017 Accepting new patients
Alliance Physicians Inc CurrentSince May 1, 2017 Accepting new patients

Locations

3535 Pentagon Blvd
#320
Beavercreek, OH 45431

3533 Southern Blvd
Ste 5650
Kettering, OH 45429
Phone (937) 294-3611

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3535 Southern Blvd
#1
Kettering, OH 45429

4000 Miamisburg Centerville Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 643-9939

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

7677 Yankee St
Ste 140
Washington Township, OH 45459
Phone (866) 224-9472

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

1141 N Monroe Dr
#3
Xenia, OH 45385

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1649722786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD STE 100",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-866-0637",
            "fax_number": "937-866-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD STE 100",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-866-0637",
            "fax_number": "937-866-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO-CORDERO",
        "first_name": "SHASLING",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209840",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdelgadocordero569686@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 100",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 100",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.