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DR. ETHAN SHAMIS MB BCH BAO
NPI 1477258929
Student in an Organized Health Care Education/Training Program in Scranton, PA

Active since April 04, 2023PECOS Enrolled
501 SOUTH WASHINGTON AVENUE, SCRANTON, PA 18505(570) 591-5153 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 6, 2023, Oct 27, 2023, Apr 4, 2023 (3 updates tracked since 2023).

About Dr. Ethan Shamis Mb Bch Bao NPPES

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

DR. ETHAN SHAMIS MB BCH BAO (NPI 1477258929) is an individual student in an organized health care education/training program in Scranton, Pennsylvania and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477258929
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. ETHAN SHAMISCredential: MB BCH BAO
Location Address501 SOUTH WASHINGTON AVENUEScranton, PA 18505
Mailing AddressThe Wright Center For Graduate Medical Education, 501 South Washington AvenueScranton, PA 18505 · (570) 591-5153 · Fax (570) 343-4800
Phone(570) 591-5153
Sole ProprietorNo
Enumeration DateApril 4, 2023
Last NPPES UpdateDecember 6, 20233 updates tracked since enumeration
NPPES CertifiedApril 4, 2023
✔ NPI 1477258929 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.

501 SOUTH WASHINGTON AVENUE, Scranton, PA 18505
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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. Ethan Shamis Mb Bch Bao 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 20

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

RUHI GORAYA M.D.
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE, SUITE 1000
SCRANTON, PA 18505
Lackawanna County (570) 591-5131
MS. HARLEEN KAUR NEELON M.D.
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 591-5131
TUSHAR ABHINAV M.B.B.S
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 591-5153
SANTOSH KHANAL MBBS
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 591-5153
FATIMA RAJA M.D
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 892-8807
DHRUV PATEL M.D.
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 591-5153
ABDULLAH RASHEED MINHAS MD
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 892-8807
SALMA WAQAR M.D.
Student in an Organized Health Care Education/Training Program
501 SOUTH WASHINGTON AVENUE
SCRANTON, PA 18505
Lackawanna County (570) 892-8807

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 Ethan Shamis's NPI number?

The NPI number for Ethan Shamis is 1477258929. It was assigned to this individual provider in the NPPES registry on April 4, 2023.

Where is Ethan Shamis located?

Ethan Shamis practices at 501 South Washington Avenue, Scranton, PA 18505. The listed phone number is (570) 591-5153.

What is Ethan Shamis's specialty?

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

Is Ethan Shamis enrolled in Medicare?

Yes. Ethan Shamis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Shamis was last updated on December 6, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.