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MS. SELENA SHAMO
NPI 1124844014
Physician Assistant in Detroit, MI

Active since November 25, 2024PECOS Enrolled
259 MACK AVE STE 2590, DETROIT, MI 48201(313) 577-1716 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Selena Shamo NPPES

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

MS. SELENA SHAMO (NPI 1124844014) is an individual physician assistant in Detroit, Michigan, licensed in Michigan (1235097) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Wayne State University School Of Medicine (2025).

NPPES Registry Identity

NPI1124844014
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. SELENA SHAMO
Location Address259 MACK AVE STE 2590Detroit, MI 48201-2427
Mailing Address259 Mack Ave Ste 2590Detroit, MI 48201-2427
Phone(313) 577-1716
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2025
Enumeration DateNovember 25, 2024
Last NPPES UpdateJune 18, 2025
NPPES CertifiedJune 18, 2025
✔ NPI 1124844014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 1235097
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
259 MACK AVE STE 2590, Detroit, MI 48201
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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)

Ms. Selena Shamo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557872314
PECOS Enrollment IDI20250618000861
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230019
Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

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.

BROOKE MORGAN ADEMA
Physician Assistant
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1716
ALLISON BAUER
Physician Assistant
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1716
ELIZABETH ROBIN NEWBERGER
Physician Assistant
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1368
RAECHEL MCKIERNAN
Physician Assistant (Surgical)
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1716
NICOLE BROOKE LANGAN PA-C
Physician Assistant
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1716
BRITTANY TAYLOR LIPCSIK
Physician Assistant
259 MACK AVE STE 2590
DETROIT, MI 48201
Wayne County (313) 577-1716

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 Selena Shamo's NPI number?

The NPI number for Selena Shamo is 1124844014. It was assigned to this individual provider in the NPPES registry on November 25, 2024.

Where is Selena Shamo located?

Selena Shamo practices at 259 Mack Ave Ste 2590, Detroit, MI 48201. The listed phone number is (313) 577-1716.

What is Selena Shamo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Selena Shamo enrolled in Medicare?

Yes. Selena Shamo is registered in the Medicare PECOS enrollment system.

Is Selena Shamo affiliated with any hospitals?

According to CMS data, Selena Shamo is affiliated with Ascension Providence Hospital, Southfield And Novi.

When was this NPI record last updated?

The NPPES record for Selena Shamo was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.