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SHANE SAMPSON MD
NPI 1306532734
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 18, 2023PECOS EnrolledAccepts Medicare Assignment
4201 SAINT ANTOINE, STE., 8C-UHC, DETROIT, MI 48201(313) 745-1302 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2025, Aug 11, 2023 (2 updates tracked since 2023).

About Shane Sampson Md NPPES

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

SHANE SAMPSON MD (NPI 1306532734) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1306532734
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHANE SAMPSONCredential: MD
Location Address4201 SAINT ANTOINE, STE., 8C-UHCDetroit, MI 48201
Mailing Address3990 John R StDetroit, MI 48201-2018 · (313) 745-6035
Phone(313) 745-1302
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 18, 2023
Last NPPES UpdateJune 13, 20252 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
✔ NPI 1306532734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 4301514609 (MI)
4201 SAINT ANTOINE, STE., 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 and accepts Medicare assignment

Shane Sampson Md 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 ID4486011566
PECOS Enrollment IDI20250620002943
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.

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 Sampson's NPI number?

The NPI number for Shane Sampson is 1306532734. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Where is Shane Sampson located?

Shane Sampson practices at 4201 Saint Antoine, Ste. 8c-Uhc, Detroit, MI 48201. The listed phone number is (313) 745-1302.

What is Shane Sampson's specialty?

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

Is Shane Sampson enrolled in Medicare?

Yes. Shane Sampson 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.

When was this NPI record last updated?

The NPPES record for Shane Sampson was last updated on June 13, 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.