Shayne Sumida, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

8850 E Pima Center Pkwy
Scottsdale, AZ 85258-4619

Phone

(480) 800-3900

Fax

(480) 800-3985

NPI assigned

Apr 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1881257376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 E PIMA CENTER PKWY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584619",
            "telephone_number": "480-800-3900",
            "fax_number": "480-800-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 E PIMA CENTER PKWY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584619",
            "telephone_number": "480-800-3900",
            "fax_number": "480-800-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMIDA",
        "first_name": "SHAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "IN-10198928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Michael Sullivan, D.O.
• Stacey J Sullivan, M.D.
• Susan B Sullivan, RPH
• Kayla Dawn Sumberg, N.M.D.
• Sumer Statler Aeed, LLC
• Joseph D Summers, M.D.
• Savanna D Summerville, RBT
• Summit Aesthetics LLC
• Summit Foot and Ankle Specialists, LLC
• Summit Medical DME

• Student in an Organized Health Care Education/Training Program in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.

Verify at the official NPI Registry.