Shaju Shamsuddin (NPI# 1982696878, PAC ID# 9931152014) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1982696878 |
| PAC ID by PECOS | 9931152014 |
| Professional Enrollment ID | I20151002001052 |
| Full Name | Shaju Shamsuddin |
| Organization Legal Name | NEO UROLOGY ASSOCIATES INC |
| Address |
6262 Mahoning Ave C Austintown OH 44515-2003 |
| Phone Number | 3307796851 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1989 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 8628088036 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210001 | MERITUS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6262 Mahoning Ave, C, Austintown, OH 44515-2003 | 3307796851 | NEO UROLOGY ASSOCIATES INC |
| 11110 Medical Campus Rd, Suite 129, Hagerstown, MD 21742-6799 | 3016654650 | GAGNON ONCOLOGY LLC |
| 6262 Mahoning Ave B, Youngstown, OH 44515-2003 | 3307589787 | TRIAD HEALTH SERVICES LLC |
| Organization Legal Name | NEO UROLOGY ASSOCIATES INC |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carl R Peterson Iii | Radiation Oncology | Neo Urology Associates Inc | 627 Eastland Ave Se, Suite 201, Warren, OH 44484-4501 |
| Mehran Saboori | Radiation Oncology | Neo Urology Associates Inc | 6262 Mahoning Ave, C, Austintown, OH 44515-2003 |
| Daniel Joseph Ricchiuti | Urology | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Cortney A Birchak | Nurse Practitioner | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Rashad El-dabh | Radiation Oncology | Neo Urology Associates Inc | 627 Eastland Ave Se, Suite 201, Warren, OH 44484-4501 |
| Munir Ahmad | Radiation Oncology | Neo Urology Associates Inc | 627 Eastland Ave Se, Suite 201, Warren, OH 44484-4501 |
| Mark A Memo | Urology | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Robert Ricchiuti | Urology | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Patrick Frost | Nurse Practitioner | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Richard A Memo | Urology | Neo Urology Associates Inc | 7430 Southern Blvd, Boardman, OH 44512-5629 |
| Street Address |
6262 MAHONING AVE C |
| City | AUSTINTOWN |
| State | OH |
| Zip | 44515-2003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mehran Saboori | Radiation Oncology | Neo Urology Associates Inc | 6262 Mahoning Ave, C, Austintown, OH 44515-2003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Johnson | Nurse Practitioner | On Demand Counseling LLC | 5760 Patriot Blvd, Suite C, Austintown, OH 44515-1170 |
| Theodore R Cubbison | Internal Medicine | On Demand Counseling LLC | 5760 Patriot Blvd, Suite C, Austintown, OH 44515-1170 |
| Carli Held | Physician Assistant | On Demand Counseling LLC | 5760 Patriot Blvd, Suite C, Austintown, OH 44515-1170 |
| Luis E Villaplana | Internal Medicine | 5760 Patriot Blvd, Suite B, Austintown, OH 44515-1170 | |
| Gregory Facemyer | Family Medicine | 5121 Mahoning Ave, Suite 201, Youngstown, OH 44515-1800 | |
| Nicolle Pascarella | Clinical Social Worker | Advanced Counseling Solutions LLC | 5204 Mahoning Ave, Suite 105, Youngstown, OH 44515-1808 |
| Christopher Rossvanes | Clinical Social Worker | Advanced Counseling Solutions LLC | 5204 Mahoning Ave, Suite 105, Youngstown, OH 44515-1808 |
| Jaymi Wendt | Clinical Social Worker | Advanced Counseling Solutions LLC | 5204 Mahoning Ave, Suite 105, Youngstown, OH 44515-1808 |
| Theresa Bohr | Clinical Social Worker | Advanced Counseling Solutions LLC | 5204 Mahoning Ave, Suite 105, Youngstown, OH 44515-1808 |
| Joseph Simons | Clinical Social Worker | Advanced Counseling Solutions LLC | 5204 Mahoning Ave, Suite 105, Youngstown, OH 44515-1808 |
| Find all physicians in zip 44515 | |||
| City | AUSTINTOWN |
| Zip Code | 44515 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | AUSTINTOWN + RADIATION ONCOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.