Individual provider Active NPI

Shanna Mae Naomi Mastrangelo, FNP-C, CPM

  • Family Nurse Practitioner
  • Martinsburg, WV
National Provider Identifier
1962747048
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105987 Issued in WV
Practice address
5187 Arden Nollville Rd
Martinsburg, WV 25403-6113
Phone
(301) 991-7414
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X
Family Nurse Practitioner 363LF0000X AC006009 MD
Family Nurse Practitioner 363LF0000X 105987 WV Primary

Addresses

Primary practice location

5187 Arden Nollville Rd
Martinsburg, WV 25403-6113

Mailing address

5187 Arden Nollville Rd
Martinsburg, WV 25403-6113
Phone (301) 991-7414

Other practice location 1

13620 Crayton Blvd Ste A
Hagerstown, MD 21742-2335
Phone (240) 313-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231226001685 MD Practitioner - Nurse Practitioner 6709236227 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
75.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
105987WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Urgent Care LLC CurrentSince Nov 22, 2023 Accepting new patients
Meritus Urgent Care, LLC CurrentSince Nov 22, 2023 Accepting new patients
Meritus Medical Center Inc CurrentSince Jun 4, 2024 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Mep Health, LLC CurrentSince Jun 9, 2024 Accepting new patients
Meritus Medical Center Inc CurrentSince Jun 4, 2024 Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

13620 Crayton Blvd
Ste A
Hagerstown, MD 21742
Phone (240) 313-3100

13620 Crayton Blvd
Hagerstown, MD 21742
Phone (240) 313-3100

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

Organizations & group practices 6

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": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1962747048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5187 ARDEN NOLLVILLE RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254036113",
            "telephone_number": "301-991-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5187 ARDEN NOLLVILLE RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254036113",
            "telephone_number": "301-991-7414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13620 Crayton Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422335",
            "country_code": "US",
            "telephone_number": "240-313-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTRANGELO",
        "first_name": "SHANNA",
        "middle_name": "MAE NAOMI",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC006009",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "105987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.