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Physician Compare National (NPI:1710290804)

HEALTHCARE PROVIDER: SHELLEY CHEN GOODEN CRNA

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1710290804
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2264624709
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20101004000049
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GOODEN
Individual professional last name
Provider First Name SHELLEY
Individual professional first name
Provider Middle Name CHEN
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Individual professional's medical school
Graduation Year 2010
Individual professional's medical school graduation year
Primary Specialty CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name MIAMI ANESTHESIA SERVICES LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 1355651837
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 5
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 5959 NW 7TH ST
Group Practice or individual's line 1 address
Line 2 Street Address THE MIAMI MEDICAL CENTER
Group Practice or individual's line 2 address
City MIAMI
Group Practice or individual's city
State FL
Group Practice or individual's state
Zip Code 331263129
Group Practice or individual's zip code (9 digits when available)
Phone Number 3522562855
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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