Carolyn F Shelak, MD, PHD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

MD29218 Issued in OR

Practice address

2801 N Gantenbein Ave
Legacy Emanuel Children'S Hospital
Portland, OR 97227-1623

Phone

(503) 413-3540

NPI assigned

Jan 30, 2007

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 OR

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, Doctor of Philosophy

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.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1972649283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-413-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "address_2": "LEGACY EMANUEL CHILDREN'S HOSPITAL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELAK",
        "first_name": "CAROLYN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OR",
            "license": "MD29218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Liane Shehab, PSY.D.
• Amina Burey Sheikh-Wali
• Melissa Anne Sheiko, M.D.
• Christina Sheinin
• Matthew Gilbert Sheinin, M.D.
• Michael A Shelak, OTR/L
• Joan Marguerite Shelby, ANP
• Wendy Shelden
• Angela Sheldon
• Candice Ray Sheldon, MD

• Pediatric Critical Care Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Critical Care Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.