JIAN SHAN


Address: 30 Hagen Dr Ste 100, Rochester, NY 14625-2658
Phone: 5854425320

JIAN SHAN (NPI# 1134481427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134481427
Entity Type Individual
Full Name JIAN SHAN
Credential M.D.
Practice Address 30 Hagen Dr Ste 100
Rochester
NY 14625-2658
Mailing Address 100 Kings Highway South
Provider Enrollment
Rochester
NY 14617-5504
Practice Telephone 5854425320
Practice Fax Number 5854425526
Mailing Telephone 5859221304
Enumeration Date 2012-06-12
Last Update Date 2019-04-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
294347 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY 05416179 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
55 Lake Ave N, Worcester, MA 016550002 5083341000
2365 S Clinton Ave Ste 100, Rochester, NY 146182663 5854425320
101 Canal Landing Blvd, Rochester, NY 146265109 5852937300 5852277723
229 Summit St Ste 10, Batavia, NY 140201645 5854425320 5854425526

Office Location

Street Address 30 HAGEN DR STE 100
City ROCHESTER
State NY
Zip Code 14625-2658

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205305729 Christopher Corona Psychologist 100 Linden Oaks, Suite 102, Rochester, NY 14625 2018-11-14
1770932147 Ashley Mills Optometrist 10 Woodcrest Dr, Rochester, NY 14625 2016-06-07
1003260837 Natalia Golub Internal Medicine 30 Hagen Dr Ste 320, Rochester, NY 14625 2016-04-18
1386051688 Amelia K Caraway Physician Assistant 20 Hagon Dr., Suite 300, Rochester, NY 14625 2014-07-18
1750793980 Eileen M Wayne Registered Nurse 36a Brook Hill Lane, Rochester, NY 14625 2014-05-22
1003241068 Timothy Sterling Cooper Chiropractor 2480 Browncroft Blvd Ste 118, Rochester, NY 14625 2013-09-10
1740556265 Kelly M Limbeck Speech-Language Pathologist 2590 Atlantic Avenue, Denfield, NY 14625 2012-03-29
1952691743 Sandra Anne Swanson Massage Therapist 1694 Penfield Rd., Catalyst Health Group, Rochester, NY 14625 2011-04-13
1396994109 Celso E Dias Surgery 30 Hagen Dr Suite 120, Rochester, NY 14625 2008-09-17
1568643849 Richard F. Eagleton Pharmacist 1601 Penfield Road, Rochester, NY 14625 2007-11-15
Find all providers in zip 14625

Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033619515 Jrk Medical LLC Internal Medicine 2633 Superior Dr Nw Ste 100, Rochester, MN 55901-8395 2018-02-20
1265722508 Erica Olson Miller Internal Medicine 600 Red Creek Dr Ste 100, Rochester, NY 14623 2011-04-07
1427347509 Nicholas Mckenzie Venci Internal Medicine 140 Canal View Blvd Ste 102, Rochester, NY 14623-2808 2011-03-29
1952690026 John Michael Nayda Internal Medicine Unisersity of Rochester Strong Memorial, Division of Cardiology Box 679a, Rochester, NY 14642-0001 2011-03-29
1114242500 Michael Vornovitsky Internal Medicine 601 Elmwood Ave Box 679a, Rochester, NY 14642-0001 2010-03-29
1629302013 Marvin Galler Internal Medicine 300 Hylan Dr, # 107, Rochester, NY 14623-4216 2009-10-01
1952544652 Kiran Devaraj Internal Medicine 1870 Winton Rd S Ste 1, Rochester, NY 14618-3960 2009-04-09
1326295536 John Allen Spittell Jr. Internal Medicine 614 Memorial Pkwy Sw, Rochester, MN 55902-6349 2008-08-20
1114010865 Gregory Mark Singer Internal Medicine 2664 Ridgeway Ave, Rochester, NY 14626-4209 2006-10-02
1689786477 Harry E Mccrea IIi Internal Medicine 101 Canal Landing Blvd Ste 8, Rochester, NY 14626-5109 2006-08-31
Find all providers in ROCHESTER

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City ROCHESTER
Zip Code 14625

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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