Individual provider Active NPI

Shabana Shahanavaz, MD

  • Pediatric Cardiology Physician
  • Cincinnati, OH
National Provider Identifier
1811229107
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
35.140161 Issued in OH
Practice address
3333 Burnet Ave
MLC 2003
Cincinnati, OH 45229-3026
Phone
(513) 636-4432
Fax
(513) 636-3952
NPI assigned
Feb 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 54308 KY
Pediatric Cardiology Physician 2080P0202X 2011031514 MO
Pediatric Cardiology Physician 2080P0202X 01092178A IN
Pediatric Cardiology Physician 2080P0202X 35.140161 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
MLC 2003
Cincinnati, OH 45229-3026

Mailing address

1 Childrens PL
NWT 8328 CB 8116
Saint Louis, MO 63110-1002
Phone (314) 454-6095

Other practice location 1

UK Healthcare
800 Rose Street
Lexington, KY 40503
Phone (859) 323-5000

Other practice location 2

8333 Naab Rd Ste 320
Indianapolis, IN 46260-1983
Phone (317) 338-3000

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL
1811229107MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH, IN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210127002623 KY Practitioner - Cardiovascular Disease (Cardiology) 1254503014 Reassigns benefits to 1 organization
I20210127002679 OH Practitioner - Cardiovascular Disease (Cardiology) 1254503014 Reassigns benefits to 1 organization
I20240315000202 IN Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 1254503014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Medical CenterGroup PAC ID 8426955733, 716 clinicians

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011031514MOMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Feb 3, 2024 Accepting new patients
University of Kentucky CurrentSince Jan 1, 2021 Accepting new patients
Children'S Hospital Medical Center Pediatrics CurrentSince Oct 27, 2020 Accepting new patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Feb 3, 2024 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8333 Naab Rd
Ste 320
Indianapolis, IN 46260
Phone (317) 338-3000

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
#2003
Cincinnati, OH 45229
Phone (513) 636-4432

Interoperability endpoints

  • Direct secure messaging: sshahanavaz367458@direct.uchealth.com

Organizations & group practices 4

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": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1811229107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "NWT 8328 CB 8116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6095",
            "fax_number": "314-454-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2003",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4432",
            "fax_number": "513-636-3952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UK Healthcare",
            "address_2": "800 Rose Street",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40503",
            "country_code": "US",
            "telephone_number": "859-323-5000",
            "fax_number": "859-257-3347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8333 Naab Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601983",
            "country_code": "US",
            "telephone_number": "317-338-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHANAVAZ",
        "first_name": "SHABANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KY",
            "license": "54308",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2011031514",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IN",
            "license": "01092178A",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.140161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811229107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.