Active NPI
Shavonne Osiakwan
- Surgery Physician
- York, PA
National Provider Identifier
1790532059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MT234523
- Practice address
- 1001 S George St
York, PA 17403-3676 - Phone
- (717) 851-2427
- Fax
- (717) 851-3559
- NPI assigned
- May 3, 2024
- Last updated
- May 30, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | MT234523 | PA | Primary |
Addresses
Primary practice location
1001 S George St
York, PA 17403-3676
Mailing address
1001 S George St
York, PA 17403-3676
Phone (717) 851-2427
Other practice location 1
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250722001847 | PA | Order and Referring Only - General Surgery | 8123534633 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1790532059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 S GEORGE ST",
"city": "YORK",
"state": "PA",
"postal_code": "174033676",
"telephone_number": "717-851-2427",
"fax_number": "717-851-3559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S GEORGE ST",
"city": "YORK",
"state": "PA",
"postal_code": "174033676",
"telephone_number": "717-851-2427",
"fax_number": "717-851-3559"
}
],
"practiceLocations": [
{
"address_1": "600 S Paulina St Ste 403",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606123806",
"country_code": "US",
"telephone_number": "312-942-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OSIAKWAN",
"first_name": "SHAVONNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-03",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT234523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in York, PA
- Orthopedic Surgery Institute, Inc
- Loymarie Ortiz Altiery
- Krystal Michelle Ortiz-Borrero, ATS
- Arleen Marie Ortiz, MD
- Berney N Ortiz Jr., MA
- Rashin Osman
- Oss Orthopaedic Hospital, LLC (OSS Health DME WY)
- Oss Orthopaedic Hospital, LLC (OSS Health)
- Oss Orthopaedic Hospital, LLC (OSS Health)
- Oss Orthopaedic Hospital, LLC (OSS Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.