Shane James Nylin, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

71299 Issued in AZ

Practice address

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Phone

(602) 865-5555

NPI assigned

Apr 5, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Anesthesiology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1942762042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5342 PONTIAC RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-865-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLIN",
        "first_name": "SHANE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "71299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Oseko Nyakundi, MSN,PMHNP-BC
• Dan Nydegger, D.D.S.
• Deric H Nye, D.O.
• Elisabetta G Nyholm-Jensen, D.C.
• Michael Nyholm-Jensen, DC
• Jessica Nystrom, FNP-C
• Callie O'Connor, MS
• Christopher Stephen O'Donnell, PT
• Grace O'Leary, LCSW, MT-BC, CT
• O'Lua Therapy LLC

• Anesthesiology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.