Individual provider Active NPI

Thomas Shellenberger, MD

  • Surgical Oncology Physician
  • Gilbert, AZ
National Provider Identifier
1730141391
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
46704 Issued in AZ
Practice address
2946 E Banner Gateway Dr
#450
Gilbert, AZ 85234-2165
Phone
(480) 256-6444
Fax
(480) 256-4734
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 46704 AZ Primary
Surgery Physician 208600000X 46704 AZ

Addresses

Primary practice location

2946 E Banner Gateway Dr
#450
Gilbert, AZ 85234-2165

Mailing address

2940 E. Banner Gateway Drive
Suite #450
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Other identifiers 1

IdentifierTypeStateIssuer
275021000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20121108000639 AZ Practitioner - Surgical OncologyPractitioner - General SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Other (Physician) 1052364734 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
University of Miami, LM Miller School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612

1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone 6028655555480256

925 E McDowell Rd
Phoenix, AZ 85006-2502
Phone (602) 521-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision14
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

LicenseStateTypeSpecialty
46704AZMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Dec 31, 2017 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Dec 31, 2017 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Sep 1, 2012 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 4, 2013 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Sep 1, 2012 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 4, 2013 Accepting new patients

Locations

2946 E Banner Gateway Dr
#450
Gilbert, AZ 85234

2940 E Banner Gateway Dr
Ste 450
Gilbert, AZ 85234
Phone (480) 256-3676

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

925 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-4498

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 2AND3
Phoenix, AZ 85006

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1441 N 12th St
Ste 3
Phoenix, AZ 85006

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

Organizations & group practices 7

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1730141391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 E. BANNER GATEWAY DRIVE",
            "address_2": "SUITE #450",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "address_2": "#450",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBERGER",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AZ",
            "license": "46704",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "46704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275021000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.