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AMY WALL SHORE M.D.
NPI 1235305566
Anesthesiology in Marina Del Rey, CA

Active since May 06, 2008PECOS EnrolledAccepts Medicare Assignment
4553 GLENCOE AVE STE 100, MARINA DEL REY, CA 90292(949) 988-7800 Get Directions Write a Review

NPPES record last updated: November 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Amy Wall Shore M.d. NPPES

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

AMY WALL SHORE M.D. (NPI 1235305566) is an individual anesthesiology provider in Marina Del Rey, California, licensed in Alabama (30993) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In Shreveport (2004).

NPPES Registry Identity

NPI1235305566
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameAMY WALL SHORECredential: M.D.
Location Address4553 GLENCOE AVE STE 100Marina Del Rey, CA 90292-7917
Mailing Address1590 Rosecrans Ave Ste DManhattan Beach, CA 90266-3716 · (310) 737-2844
Phone(949) 988-7800
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 2004
Enumeration DateMay 6, 2008
Last NPPES UpdateNovember 15, 2025
NPPES CertifiedNovember 15, 2025
✔ NPI 1235305566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Licenses✔ Licensed in AL · 30993✔ Licensed in MA · 226228✔ Licensed in CA · A123437
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
4553 GLENCOE AVE STE 100, Marina Del Rey, CA 90292
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Other Names 1

Former Name (1)Amy Suzanne Wall M.d.

Other Identifiers 9

Medicaid132224AL
Medicaid132231AL
Other051120731AL · Bcbs
Medicaid132222AL
Other051120732AL · Bcbs
Other051120734AL · Bcbs
Other051120729AL · Bcbs
Medicaid132226AL
Medicaid01600227MS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amy Wall Shore M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072672906
PECOS Enrollment IDI20130125000191
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 Reassignments

3

Medicare enrollment records show Amy Shore reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Shore Mds Medical Corp
2.5 mi
Anesthesiology
6801 PARK TER
Los Angeles, CA 90045
  • Reassigned Medicare billing, California enrollment
NPI 1427491018 (310) 665-7150
Bright Anesthesia A Professional Corporation
2.5 mi
Anesthesiology
6801 PARK TER STE 300
Los Angeles, CA 90045
  • Reassigned Medicare billing, California enrollment
  • 14 clinicians in this Medicare group
NPI 1518858356 (310) 665-7150
Westside Anesthesia Services
7.8 mi
Anesthesiology
400 N SEPULVEDA BLVD
Manhattan Beach, CA 90266
  • Reassigned Medicare billing, California enrollment
  • 67 clinicians in this Medicare group
NPI 1528381704 (310) 546-3461

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

Other Providers at the Same Location NPPES 4

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

DISC SURGERY CENTER AT MARINA DEL REY LLC
Clinic/Center (Ambulatory Surgical)
4553 GLENCOE AVE STE 100
MARINA DEL REY, CA 90292
Los Angeles County (949) 988-7828
R M DELEON M D INC
Anesthesiology
4553 GLENCOE AVE STE 100
MARINA DEL REY, CA 90292
Los Angeles County (949) 988-7800
CARLOS GARCIA MD INC
Anesthesiology
4553 GLENCOE AVE STE 100
MARINA DEL REY, CA 90292
Los Angeles County (949) 988-7800
KIANUSCH KIAI INC
Anesthesiology
4553 GLENCOE AVE STE 100
MARINA DEL REY, CA 90292
Los Angeles County (310) 912-6170

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 Amy Shore's NPI number?

The NPI number for Amy Shore is 1235305566. It was assigned to this individual provider in the NPPES registry on May 6, 2008. The provider is also known as Amy Suzanne Wall M.D..

Where is Amy Shore located?

Amy Shore practices at 4553 Glencoe Ave Ste 100, Marina Del Rey, CA 90292. The listed phone number is (949) 988-7800.

What is Amy Shore's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Amy Shore enrolled in Medicare?

Yes. Amy Shore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Amy Shore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amy Shore reassigns Medicare benefits to 3 organizations: Shore Mds Medical Corp (Los Angeles, CA), Bright Anesthesia A Professional Corporation (Los Angeles, CA) and Westside Anesthesia Services (Manhattan Beach, CA). Each 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 Amy Shore'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 Amy Shore was last updated on November 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.