SHADY MEDICAL PLLC
NPI 1487510814
Internal Medicine in East Syracuse, NY

Q: What is Shady Medical PLLC's NPI number?

The NPI number for Shady Medical PLLC is 1487510814. It was assigned to this organization in the NPPES registry on December 30, 2025.

Q: What is Shady Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since December 30, 2025CLIA 33D2338781 · Waiver

5015 CAMPUSWOOD DR STE 207, EAST SYRACUSE, NY 13057(607) 429-8590 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 7, 2026, Dec 30, 2025 (2 updates tracked since 2025).

On this page

About Shady Medical Pllc NPPES

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

SHADY MEDICAL PLLC (NPI 1487510814) is a healthcare organization registered as an internal medicine in East Syracuse, New York and active in the NPI registry since December 2025. The organization holds a CLIA Waiver certificate valid through February 17, 2028 and lists Amr Shady, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1487510814

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameSHADY MEDICAL PLLC

Location Address5015 CAMPUSWOOD DR STE 207East Syracuse, NY 13057-4232

Mailing Address5015 Campuswood Dr Ste 207East Syracuse, NY 13057-4232 · (315) 541-4445 · Fax (844) 689-4093

Phone(607) 429-8590

Organization SubpartNo

Authorized OfficialAmr ShadyAuthorized Official · (315) 541-4445

Enumeration DateDecember 30, 2025

Last NPPES UpdateMay 7, 20262 updates tracked since enumeration

NPPES CertifiedMay 7, 2026

✔ NPI 1487510814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

5015 CAMPUSWOOD DR STE 207, East Syracuse, NY 13057

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shady Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shady Medical PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Amr Shady, MD

Internal Medicine

NPI 1417948928

5015 CAMPUSWOOD DR STE 207
East Syracuse, NY 13057

(315) 541-4445

✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2338781

Shady Medical PLLC · East Syracuse, NY

Active · expires Feb 17, 2028

CLIA Number33D2338781

Laboratory TypePhysician Office

Certificate Effective DateFebruary 18, 2026

Certificate Expiration DateFebruary 17, 2028

Laboratory DirectorAmr A. Shady

Laboratory Phone(315) 541-4445

Laboratory LocationShady Medical PLLC5015 Campuswood Drive Suite 207, East Syracuse, NY 13057

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Shady Medical PLLC's NPI number?

The NPI number for Shady Medical PLLC is 1487510814. It was assigned to this organization in the NPPES registry on December 30, 2025.

Where is Shady Medical PLLC located?

Shady Medical PLLC is located at 5015 Campuswood Dr Ste 207, East Syracuse, NY 13057. The listed phone number is (607) 429-8590.

What is Shady Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Shady Medical PLLC enrolled in Medicare?

Yes. Shady Medical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shady Medical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Shady Medical PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Shady Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2338781) is associated with this NPI, valid through February 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Shady Medical PLLC was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.