Shania D Mardian, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

105634 Issued in IA

Practice address

330 Dakota Dunes Blvd
Dakota Dunes, SD 57049-5461

Phone

(605) 422-3000

Fax

(605) 422-3001

NPI assigned

Dec 18, 2020

Last updated

May 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shania D Shull Former name

Medicare fee-for-service enrollment

Enrolled in IA, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermsd LLCGroup PAC ID 5597153072, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sshull196395@uihcdirect.org

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.

• Dermsd LLC

  • Dermatology Physician
  • Dakota Dunes, SD
  • NPI 1801465976

  IA

  Medicare reassignment Care Compare group
• Winnebago Tribe of Nebraska

  dba Winnebago Comprehensive Healthcare Systems

  • Clinic/Center
  • Winnebago, NE
  • NPI 1033608328

  TX

  Medicare reassignment NPD
• Winnebago Tribe of Nebraska

  dba Winnebago Tribal Rescue and Ambulance

  • Land Ambulance
  • Winnebago, NE
  • NPI 1295720811
  NPD

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

• Northwest Iowa Hospital Corporation

  dba St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Sioux City, IA
  • NPI 1962594622
  Care Compare affiliation

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1649866138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 DAKOTA DUNES BLVD STE 400",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495462",
            "telephone_number": "605-422-3000",
            "fax_number": "605-422-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 DAKOTA DUNES BLVD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495461",
            "telephone_number": "605-422-3000",
            "fax_number": "605-422-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIAN",
        "first_name": "SHANIA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "105634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANIA",
            "last_name": "SHULL",
            "middle_name": "D",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzanne R Lyman, CRNA
• Melvin Lynn, LMSW
• Lindsay Marie Macklem, RN
• Maguire Boonstra Inc (Advanced Prosthetics Center)
• Yorell Manon-Matos, MD
• Rosa Maria Marquez, PA-C
• Brandon David Marreel, ATC; MA
• Douglas Wayne Martin, MD
• Robert P Marx, DDS
• Zachary Mathers, ATHLETIC TRAINER

• Physician Assistant in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.