Individual provider Active NPI

Yasser Shaheen, MD

  • Interventional Pain Medicine Physician
  • Cheshire, CT
National Provider Identifier
1881674398
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
042472 Issued in CT
Practice address
677 S Main St
Cheshire, CT 06410-3158
Phone
(203) 439-0050
Fax
(203) 439-9490
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 042472 CT Primary

Addresses

Primary practice location

677 S Main St
Cheshire, CT 06410-3158

Mailing address

677 S Main St
Cheshire, CT 06410-3158
Phone (203) 439-0050

Other identifiers 2

IdentifierTypeStateIssuer
0445130MedicaidIA
D400193195OtherCTMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20080728000453 CT Practitioner - Pain ManagementPractitioner - Anesthesiology 9133191042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

677 S Main St
Cheshire, CT 06410-3158
Phone (203) 439-0050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042472CTMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Clinic PC Interventional Pain Medicine CurrentSince Nov 1, 2014 Accepting new patients
Waterbury Anesthesiology Assoc. Inc Past Accepting new patients
General Anesthesia Specialists Partnership Medical Group Past Accepting new patients
Quality Surgicenter LLC Past Accepting new patients
Providence Interventional Pain,LLC Past Accepting new patients

Locations

677 S Main St
Cheshire, CT 06410
Phone (203) 250-7577

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDEICA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDEICA/Endpoint/FDEICA

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1881674398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103158",
            "telephone_number": "203-439-0050",
            "fax_number": "203-439-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103158",
            "telephone_number": "203-439-0050",
            "fax_number": "203-439-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "YASSER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CT",
            "license": "042472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445130",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D400193195",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.