DR. SHADY AHMED HASSANIEN EZALDIN MD - NPI 1043957970 - Student in an Organized Health Care Education/Training Program in Charleston, WV

Q: What is Shady Ezaldin's NPI number?

The NPI number for Shady Ezaldin is 1043957970. It was assigned to this individual provider in the NPPES registry on May 12, 2022.

Q: What is Shady Ezaldin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Shady Ezaldin was last updated on August 22, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Shady Ahmed Hassanien Ezaldin Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHADY AHMED HASSANIEN EZALDIN MD (NPI 1043957970) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043957970

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. SHADY AHMED HASSANIEN EZALDINCredential: MD

Location Address3200 MACCORKLE AVENUE SOUTHEAST, ROBERT C. BIRD CLINICAL TEACHING CENTER, 4TH FLOORCharleston, WV 25304

Mailing Address3200 Maccorkle Avenue Southeast, Robert C. Bird Clinical Teaching Center, 4th FloorCharleston, WV 25304 · (304) 388-5590 · Fax (304) 388-8238

Phone(304) 388-5590

Fax(304) 388-8238

Sole ProprietorNo

Enumeration DateMay 12, 2022

Last NPPES UpdateAugust 22, 20222 updates tracked since enumeration

NPPES CertifiedAugust 22, 2022

✔ NPI 1043957970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3200 MACCORKLE AVENUE SOUTHEAST, Charleston, WV 25304

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shady Ahmed Hassanien Ezaldin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MOUHAMMED AIMAN SAKKAL MD

Internal Medicine

3200 MACCORKLE AVENUE SOUTHEAST, ROBERT C. BIRD CLINICAL TRAINING CENTER
CHARLESTON, WV 25304

Kanawha County (304) 388-5590

PRAKRATI YADAV MBBS