Individual provider Active NPI

Shamane I Onwudiachi, PA-C

  • Physician Assistant
  • Catonsville, MD
National Provider Identifier
1780944892
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0004197 Issued in MD
Practice address
6333 Baltimore National Pike
Catonsville, MD 21228-3910
Phone
(443) 514-1361
NPI assigned
May 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004197 MD Primary

Addresses

Primary practice location

6333 Baltimore National Pike
Catonsville, MD 21228-3910

Mailing address

12807 N Point LN
Laurel, MD 20708-2341

Other practice location 1

805 Washington Blvd S
Laurel, MD 20707-4611
Phone (301) 725-0422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130606000086 MD Practitioner - Physician Assistant 4789822529 Reassigns benefits to 5 organizations
I20220713000795 DC Practitioner - Physician Assistant 4789822529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Maryland Medical Group PLLC 258 clinicians
U N I Medical Care Inc 21 clinicians

Practice addresses (Care Compare)

10210 Reisterstown Rd
Owings Mills, MD 21117-3606
Phone (410) 902-6776

10424 Baltimore Ave
Beltsville, MD 20705-2321
Phone (240) 542-5987

1110 Annapolis Rd
Odenton, MD 21113-1602
Phone (443) 351-3917

13671 Georgia Ave
Aspen Hill, MD 20906-5214
Phone (240) 514-0000

2051 W St
Annapolis, MD 21401-3006
Phone (443) 603-0758

2855 Crain Hwy
Waldorf, MD 20601-2807
Phone (240) 427-1926

5900 Cedar LN
Columbia, MD 21044-3635
Phone (443) 718-4067

6201 Annapolis Rd
Landover Hills, MD 20784-1307
Phone (301) 276-3377

6333 Baltimore Nat Pike
Catonsville, MD 21228-3910
Phone (443) 514-1361

7116 Ritchie Hwy
Glen Burnie, MD 21061-2904
Phone (443) 577-0277

726 Rockville Pike
Rockville, MD 20852-1133
Phone (240) 238-0411

826 Washington Rd
Suite 110a
Westminster, MD 21157-5779
Phone (410) 751-7480

8830 Belair Rd
Baltimore, MD 21236-2401
Phone (410) 529-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004197MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Maryland Medical Group, PLLC Current Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Jan 31, 2024 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Jan 31, 2024 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Jan 31, 2024 Accepting new patients
CRH MD Management LLC CurrentSince Jul 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

6333 Baltimore National Pike
Catonsville, MD 21228
Phone (443) 514-1361

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1780944892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12807 N POINT LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 BALTIMORE NATIONAL PIKE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212283910",
            "telephone_number": "443-514-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Washington Blvd S",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207074611",
            "country_code": "US",
            "telephone_number": "301-725-0422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONWUDIACHI",
        "first_name": "SHAMANE",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.