Erum Shahab, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0431121 Issued in CT

Practice address

16 Main St
Ellington, CT 06029-3360

Phone

(860) 871-5402

Fax

(860) 871-5413

NPI assigned

Apr 3, 2006

Last updated

Dec 21, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waire LLCGroup PAC ID 4183782360, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Waire LLC

  dba ellington behavioral health

  • Psychiatry Physician
  • Ellington, CT
  • NPI 1871744243
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1669434049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAIN ST",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293360",
            "telephone_number": "860-871-5402",
            "fax_number": "860-871-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MAIN ST",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293360",
            "telephone_number": "860-871-5402",
            "fax_number": "860-871-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAB",
        "first_name": "ERUM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CT",
            "license": "0431121",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "043112",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "0431121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669434049",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Harvey Scherick, DDS
• Denise Ann Scheuy, LPC
• Kelly Ann Schmidt, PH.D.
• Ronald J Seagrave
• Doreen Seitz, PT
• Nashe Smith, CCC-SLP
• Loree Soloway, RPH
• Lorinda B Spivey, LCSW
• Matthew G Steele, APRN, CRNA
• Melissa A Sullivan, RD, CD-N

• Psychiatry Physician in Ellington, CT
• Providers in Ellington, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.