Shaju Shamsuddin, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

35.069956 Issued in OH

Practice address

667 Eastland Ave SE
Warren, OH 44484-4503

Phone

(330) 841-4126

Fax

(330) 841-4598

NPI assigned

Aug 17, 2005

Last updated

Jan 1, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH, MD2 enrollments

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 2

Specialty

Radiation Oncology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Gagnon Oncology LLCGroup PAC ID 5496913030, 4 clinicians

Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Neo Urology Associates IncGroup PAC ID 8628088036, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001
• University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sshamsuddin192683@direct.bsmhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neo Urology Associates Inc

  • Urology Physician
  • Boardman, OH
  • NPI 1598798878
  Medicare reassignment Care Compare group NPD
• Triad Health Services, LLC

  dba Southwoods Physician Services

  • Plastic Surgery Physician
  • Youngstown, OH
  • NPI 1588925457
  Medicare reassignment Care Compare group NPD
• Gagnon Oncology, LLC

  • Radiation Oncology Physician
  • Frederick, MD
  • NPI 1376814293
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225
  Medicare reassignment NPD
• Mercy Health Physicians Youngstown, LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1154636066
  Medicare reassignment NPD
• Mercy Health Physicians Youngstown LLC

  dba Mercy Health - Boardman Orthopaedics

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1750920245
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD
• Gagnon Oncology, LLC

  • Radiation Oncology Physician
  • Hagerstown, MD
  • NPI 1568270619
  NPD
• Dermatology Associates of Youngstown Inc

  • Dermatology Physician
  • Youngstown, OH
  • NPI 1033205216
  NPD (past)
• The Surgery Center at Southwoods, LLC

  dba The Surgical Hospital at Southwoods

  • Special Hospital
  • Youngstown, OH
  • NPI 1740398890
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Radiation Oncology Affiliates of Maryland

  • Specialist
  • Baltimore, MD
  • NPI 1912977984
  NPD (past)

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

• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  Care Compare affiliation
• University of Maryland Medical Center, LLC

  dba University of Maryland Medical Center

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1174660120
  Care Compare affiliation

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1982696878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4126",
            "fax_number": "330-841-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4126",
            "fax_number": "330-841-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMSUDDIN",
        "first_name": "SHAJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD062322L",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35.069956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101275823",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H440680",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2075301",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reshashree Shah, MD
• Roopshri Sunilkumar Shah, MD
• Vijaykumar Sankalchand Shah, MD
• Priyanka Shahi, MD
• Parvin P Shaibani, MD
• Shared Medical Imaging Inc
• Diane Sharnek, MS/PC
• Sharon George DO Inc
• Tonya D Sharp, LMT
• Melissa A. Sharper

• Radiation Oncology Physician in Warren, OH
• Providers in Warren, OH by specialty
• Radiation Oncology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.