Individual provider Active NPI

Max Shenin, DO

  • Rheumatology Physician
  • Wilmington, NC
National Provider Identifier
1730380239
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2018-02982 Issued in NC
Practice address
1509 Doctors Cir
BLDG C
Wilmington, NC 28401-7403
Phone
(910) 662-7550
Fax
(910) 662-7551
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2018-02982 NC Primary

Addresses

Primary practice location

1509 Doctors Cir
BLDG C
Wilmington, NC 28401-7403

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other practice location 1

1960 S 16th St
Wilmington, NC 28401-6676
Phone (910) 662-7550

Other practice location 2

1814 New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone (910) 662-7500

Other practice location 3

584 Hospital Dr NE
Unit E
Bolivia, NC 28422-0019
Phone (910) 662-7500

Other practice location 4

1333 S Dickinson Dr
Unit 230
Leland, NC 28451-6430
Phone (910) 662-7500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health
Direct Messaging Address mshenin120966@direct.nhrmc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090714000489 PA Practitioner - Rheumatology 2860544343 Reassigns benefits to 1 organization
I20190306001480 NC Practitioner - RheumatologyPractitioner - Internal Medicine 2860544343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1509 Doctors Cir
BLDG C
Wilmington, NC 28401-7403
Phone (910) 662-7500

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Pender Memorial Hospital Hospital, Burgaw, NC, CCN 341307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
Pennsylvania Rheumatology Associates, P.C. Rheumatology CurrentSince Jul 1, 2009 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Rheumatology CurrentSince May 1, 2021 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

584 Hospital Dr NE
Unit E
Bolivia, NC 28422
Phone (910) 754-5453

1333 S Dickinson Dr
Unit 230
Leland, NC 28451
Phone (910) 254-1033

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

1509 Doctors Cir
Bldg C
Wilmington, NC 28401
Phone (910) 662-7550

1814 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 452-3666

5505 Currituck Dr
#100
Wilmington, NC 28403
Phone (910) 662-6000

1960 S 16th St
Wilmington, NC 28401
Phone (910) 343-9991

822 Pine St
Ste 3A
Philadelphia, PA 19107
Phone (215) 829-5354

Interoperability endpoints

  • Direct secure messaging: mshenin1426908@direct.novanthealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/AHGABA

Organizations & group practices 5

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 4

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1730380239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DOCTORS CIR",
            "address_2": "BLDG C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-662-7550",
            "fax_number": "910-662-7551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1960 S 16th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016676",
            "country_code": "US",
            "telephone_number": "910-662-7550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1814 New Hanover Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035350",
            "country_code": "US",
            "telephone_number": "910-662-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "584 Hospital Dr NE",
            "address_2": "Unit E",
            "address_purpose": "LOCATION",
            "city": "Bolivia",
            "state": "NC",
            "postal_code": "284220019",
            "country_code": "US",
            "telephone_number": "910-662-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1333 S Dickinson Dr",
            "address_2": "Unit 230",
            "address_purpose": "LOCATION",
            "city": "Leland",
            "state": "NC",
            "postal_code": "284516430",
            "country_code": "US",
            "telephone_number": "910-662-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENIN",
        "first_name": "MAX",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "2018-02982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1509 Doctors Cir",
            "address_2": "Bldg C",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshenin120966@direct.nhrmc.org",
            "affiliation": "N",
            "address_1": "1509 Doctors Cir",
            "address_2": "Bldg C",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.