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DR. SHANE WILLIAM WASDEN M.D.
NPI 1104083096
Obstetrics & Gynecology - Maternal & Fetal Medicine in New York, NY

Active since May 19, 2008PECOS Enrolled
91.25/100
CMS Quality Rating
130 EAST 77TH STREET, 2 BLACK HALL, NEW YORK, NY 10075(212) 434-2585 Get Directions Write a Review

NPPES record last updated: April 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Shane William Wasden M.d. NPPES

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

DR. SHANE WILLIAM WASDEN M.D. (NPI 1104083096) is an individual maternal & fetal medicine provider in New York, New York, licensed in New York (250329) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of George Washington University School Of Medicine (2007).

NPPES Registry Identity

NPI1104083096
Entity TypeIndividualMale
Primary Taxonomy207VM0101X
Provider Legal NameDR. SHANE WILLIAM WASDENCredential: M.D.
Location Address130 EAST 77TH STREET, 2 BLACK HALLNew York, NY 10075-1007
Mailing Address425 E 68th StNew York, NY 10065-6305
Phone(212) 434-2585
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2007
Enumeration DateMay 19, 2008
Last NPPES UpdateApril 27, 2023
NPPES CertifiedApril 27, 2023
✔ NPI 1104083096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Maternal & Fetal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207VM0101X
License✔ Licensed in NY · 250329
Definition
An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.
130 EAST 77TH STREET, New York, NY 10075
Open in Google Maps ↗

Other Identifiers 1

Medicaid02299585NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shane William Wasden M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658511928
PECOS Enrollment IDI20130710000008
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.

Medicare Billing Reassignment

Medicare enrollment records show Shane Wasden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Icahn School Of Medicine At Mount Sinai
1.4 mi
Obstetrics & Gynecology
1000 10TH AVE, SUITE 10C
New York, NY 10019
  • Reassigned Medicare billing, New York enrollment
  • 81 clinicians in this Medicare group
NPI 1922411065 (212) 523-3452

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina 76830
An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.
13 services13 patients
Complete ultrasound scan of pelvis 76856
A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 12

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

DR. NNEAMAKA OBIOZOR EMEAGWALI OLIVER DPM
Student in an Organized Health Care Education/Training Program
130 EAST 77TH STREET, 11 BLACK HALL
NEW YORK, NY 10075
New York County (212) 434-3284
MR. ABDULRAHMAN HATEM AMAN MD
Student in an Organized Health Care Education/Training Program
130 EAST 77TH STREET, 8TH FLOOR ROOM 801
NEW YORK, NY 10075
New York County (212) 434-2686
JACQUELINE LAGAZO-GUIA FNP
Nurse Practitioner (Family)
130 EAST 77TH STREET, 9 BLACK HALL
NEW YORK, NY 10075
New York County (212) 434-6575
CLARA DIMITRA BOYD MD
Psychiatry & Neurology (Neurology)
130 EAST 77TH STREET, BLACK HALL, 8TH FLOOR
NEW YORK, NY 10075
New York County (212) 434-6400
NATALIE CIPRIANO MD
Student in an Organized Health Care Education/Training Program
130 EAST 77TH STREET, DEPARTMENT OF SURGERY
NEW YORK, NY 10075
New York County (212) 434-2150
MR. PETER DAVID COSTANTINO MD
Specialist
130 EAST 77TH STREET, 10TH FLOOR
NEW YORK, NY 10075
New York County (212) 434-4500
DR. JASON A. ELLIS M.D.
Neurological Surgery
130 EAST 77TH STREET, DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR
NEW YORK, NY 10075
New York County (212) 434-3900
MARIA DEDIOS FNP
Nurse Practitioner (Family)
130 EAST 77TH STREET, 3 BLACK HALL
NEW YORK, NY 10075
New York County (212) 434-3900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Wasden's NPI number?

The NPI number for Shane Wasden is 1104083096. It was assigned to this individual provider in the NPPES registry on May 19, 2008.

Where is Shane Wasden located?

Shane Wasden practices at 130 East 77th Street 2 Black Hall, New York, NY 10075. The listed phone number is (212) 434-2585.

What is Shane Wasden's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Maternal & Fetal Medicine, with taxonomy code 207VM0101X.

Is Shane Wasden enrolled in Medicare?

Yes. Shane Wasden is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shane Wasden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Wasden reassigns Medicare benefits to Icahn School Of Medicine At Mount Sinai (New York, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Wasden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shane Wasden was last updated on April 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.