Individual provider Active NPI

Stephanie Shellman, FNP

  • Family Nurse Practitioner
  • Walton, NY
National Provider Identifier
1720630643
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F344656-01 Issued in NY
Practice address
130 North St
Walton, NY 13856-1299
Phone
(607) 865-6541
Fax
(607) 865-9164
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 F344656-01 NY Primary

Addresses

Primary practice location

130 North St
Walton, NY 13856-1299

Mailing address

130 North St
Walton, NY 13856-1299
Phone (607) 865-5416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191122001573 NY Practitioner - Nurse Practitioner 6002248432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753-7407
Phone (607) 746-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.41 of 100Reported as group
Quality
90.71
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F344656-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Oct 14, 2019 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Oct 14, 2019 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: sshellman335921@bassett.direct-ci.net

Organizations & group practices 2

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 5

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1720630643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561299",
            "telephone_number": "607-865-5416",
            "fax_number": "607-865-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561299",
            "telephone_number": "607-865-6541",
            "fax_number": "607-865-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLMAN",
        "first_name": "STEPHANIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344656-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walton, NY

Sources for this page

Verify at the official NPI Registry.