SHANI A FAGAN (NPI# 1477989580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477989580 |
| Entity Type | Individual |
| Full Name | SHANI A FAGAN |
| Credential | RPA-C |
| Practice Address |
158 Orchard St Rochester NY 14611-1361 |
| Practice Telephone | 5853684500 |
| Practice Fax Number | 5854366047 |
| Mailing Telephone | 5853684500 |
| Mailing Fax Number | 5854366047 |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2019-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
016834 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03743464 | 05 |
| Street Address |
158 ORCHARD ST |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14611-1361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801837620 | Cynthia Theresa Cappiello | Nurse Practitioner | 158 Orchard St, Rochester, NY 14611-1396 | 2006-06-10 |
| 1164986394 | Emily Merrick Phalon | Speech-Language Pathologist | 158 Orchard St, Rochester, NY 14611-1361 | 2019-01-22 |
| 1013418490 | Genevieve Ruiz | Social Worker | 158 Orchard St, Rochester, NY 14611-1361 | 2018-02-22 |
| 1073032835 | Mary Lugo | Speech-Language Pathologist | 158 Orchard St, Rochester, NY 14611-1361 | 2017-09-13 |
| 1376907006 | Cassandra Jolin | Family Medicine | 158 Orchard St, Rochester, NY 14611 | 2016-04-08 |
| 1487030961 | Malorie Elmer | Counselor | 158 Orchard St, Rochester, NY 14611-1361 | 2015-08-06 |
| 1083970156 | Jonathan Lee Lin | Internal Medicine | 158 Orchard St, Rochester, NY 14611-1361 | 2012-04-03 |
| 1770851909 | Damarys Baezrodriguez | Registered Nurse | 158 Orchard St, Rochester, NY 14611-1361 | 2011-12-02 |
| 1922397470 | Patricia Ann Fose | Speech-Language Pathologist | 158 Orchard St, Rochester, NY 14611-1361 | 2011-04-05 |
| 1518279827 | Kelita L Fox | Family Medicine | 158 Orchard St, Rochester, NY 14611-1361 | 2010-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578113874 | Brittany Desiree' James | Counselor | 601 Genesee Street, Rochester, NY 14611 | 2019-09-18 |
| 1629554456 | Burnagie Tafari Webbe | Licensed Practical Nurse | 49 Judson St, Rochester, NY 14611 | 2018-07-16 |
| 1194223917 | Caitlin Mucenski | Registered Nurse | 1099 Jay Street, Building J, Suite 202, Rochester, NY 14611 | 2018-01-26 |
| 1093233579 | Brittany Theresa Filip | Speech-Language Pathologist | Brittany Filip At Lincoln Park School No. 44, 820 Chili Avenue, Rochester, NY 14611 | 2017-09-05 |
| 1629591326 | Stacey D Mccloud | Licensed Practical Nurse | 55 Garfield St, Rochester, NY 14611 | 2017-07-25 |
| 1245685619 | Lilt Home Care | Home Health | 803 West Avenue, 353, Rochester, NY 14611 | 2016-05-04 |
| 1639539844 | Petrica Rouse | Dentist | 89 Genesee St Fl 2, Rochester, NY 14611 | 2016-03-01 |
| 1558737304 | People Inc. | Case Management | 835 W. Main Street, Rochester, NY 14611 | 2015-08-17 |
| 1619352051 | Lavanya Ravindran | Family Medicine | 89 Genesee St Bldg 3, Rochester, NY 14611 | 2015-07-28 |
| 1538567599 | Caring Hands Adl Inc | Home Health | 218 Garfield St., Rochester, NY 14611 | 2014-12-08 |
| Find all providers in zip 14611 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1659923704 | Colin J Montgomery | Physician Assistant | 2400 S Clinton Ave Bldg G2nd, Rochester, NY 14618-2668 | 2019-07-09 |
| 1184183592 | Jera Delibashi | Physician Assistant | 89 Genesee St Fl 3, Rochester, NY 14611-3201 | 2019-03-15 |
| 1255808309 | Lauren Leigh D'hont | Physician Assistant | 400 White Spruce Blvd Ste A, Rochester, NY 14623-1619 | 2018-10-26 |
| 1124547823 | Lucas Polito | Physician Assistant | 1724 East Ridge Road, Rochester, NY 14622 | 2017-09-13 |
| 1629523956 | Reggie Testa Cayetano | Physician Assistant | 601 Elmwood Ave Box 619-13, Rochester, NY 14642-0001 | 2016-08-16 |
| 1891248373 | Padma Priya Rathina Sabapathy | Physician Assistant | 1561 Long Pond Rd Ste 302, Rochester, NY 14626-4135 | 2016-08-01 |
| 1821407669 | Amy C Dvorak | Physician Assistant | 1425 Portland Ave # 306, Rochester, NY 14621-3001 | 2014-08-06 |
| 1154741742 | Amanda Buckner | Physician Assistant | 158 Sawgrass Dr, Floor 2, Rochester, NY 14620-4648 | 2014-04-22 |
| 1053749614 | Amy Desantis | Physician Assistant | 9 Merrydale Drive, Rochester, NY 14624 | 2013-10-17 |
| Find all providers in ROCHESTER | ||||
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| 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.