Shanelle Tashae Graham, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

20801 Issued in NY

Practice address

1 Healthy Way
Oceanside, NY 11572-1551

Phone

(516) 632-3000

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

No

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 NY

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Oceanside, NY
  • NPI 1508127531
  Medicare reassignment Care Compare group NPD
• Mount Sinai School of Medicine

  • Psychiatry Physician
  • Hempstead, NY
  • NPI 1508333956
  NPD

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

• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  Care Compare affiliation

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1972027092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 PERRY ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115505220",
            "telephone_number": "347-282-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SHANELLE",
        "middle_name": "TASHAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "20801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordy Optical, LLC
• Kelly Gorman, MD
• Alexander Gorny, M.D.
• Pavel Gozenput, M.D.
• Aidan Graham
• Melanie Greene
• Pearl Greenfield, LCSW
• Steven Greenstein, M.D.
• Grace Louise Greer, DO
• Bette Ann Grolz, R.PH.

• Medical Physician Assistant in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.