NPIMap

Individual provider Active NPI

Shiela Otwane Mbae

  • Family Nurse Practitioner
  • Latrobe, PA
National Provider Identifier
1699266452
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018591 Issued in PA
Practice address
1 Mellon Way
Latrobe, PA 15650-1197
Phone
(724) 532-1000
Fax
(724) 532-6830
NPI assigned
May 28, 2018
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018591 PA Primary

Addresses

Primary practice location

1 Mellon Way
Latrobe, PA 15650-1197

Mailing address

1 Mellon Way
Latrobe, PA 15650-1197
Phone (724) 532-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180730000018 PA Practitioner - Nurse Practitioner 9436406022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Mellon Way
Latrobe, PA 15650-1197
Phone (724) 537-1801

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018591PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

1 Mellon Way
Latrobe, PA 15650
Phone (724) 537-1207

Interoperability endpoints

  • Direct secure messaging: smbae@direct.excelahealth.org

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.

Hospital & facility affiliations 11

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": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1699266452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MELLON WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501197",
            "telephone_number": "724-532-1000",
            "fax_number": "724-532-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MELLON WAY",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501197",
            "telephone_number": "724-532-1000",
            "fax_number": "724-532-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAE",
        "first_name": "SHIELA",
        "middle_name": "OTWANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

Verify at the official NPI Registry.