Shane Selassie Anderson

Dermatopathology St Francis Community Hospital NPI1952383432

Summary

About

Shane Selassie Anderson specialises in Dermatopathology. He currently works at St Francis Community Hospital in Washington and has affiliate with 4 other institutions.

Provider Details

NPI Number 1952383432
Provider Name Shane Selassie Anderson
Credential MD
Specialization Dermatopathology
Medical School Name University Of Minnesota Medical School
Graduation Year 1996
Gender M
Entity Type Individual
PAC ID by PECOS 7911950688
Professional Enrollment ID I20050223000348
Enumeration Date 11/18/2005
Last Update Date 04/15/2010

Contact Details

Business Practice address 1001 SW KLICKITAT WAY, Seattle,
98134-1161 Washington View on Google Map
Business Practice phone 206-622-7747
Business Practice fax 206-467-1470
Mailing address PO BOX 34245, Seattle,
98124-1245 Washington View on Google Map
Other phone 206-622-7747
Other fax 206-467-1470
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Shane Selassie Anderson MD Update NPI

Payments

Total Payment Worth

$53.91
from 1 payments in the last 6 years

Total Cash or Cash Equivalent

$0.00
from 0 payments in the last 6 years

Total In-kind Items & Services

$53.91
from 1 payments in the last 6 years

Hospital Affilitation

St Francis Community Hospital in Seattle

Seattle, Washington

Harrison Medical Center

St Joseph Medical Center

Evergreenhealth Medical Center

St Anthony Hospital

Education & Training

University Of Minnesota Medical School

Dermatopathology, 1996

Group Affiliation

Organization Name PECOS PAC ID Members
The Polyclinic 2163328196 388
Surgical Associates Northwest Pc 3971596024 12
Cellnetix Pathology Pllc 8224062971 58

Public Reporting for Performance Scores

More Details

Final MIPS Score

91.20 out of 100

Score Breakdown

Quality Category Score 87.5
PI Category Score 94

 

IA Category Score 40
Cost Category Score 0
Total Patients: 90
Source of Scores: group
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Provider Taxonomy 1
Taxonomy
License No.
MD00039332 (Washington)
Primary Taxonomy
Taxonomy
License No.
MD00039332 (Washington)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1952383432
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Anderson
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Shane
The first name of the provider, if the provider is an individual.
Provider Credential Text MD PHD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address PO BOX 34245
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Seattle
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Washington
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 98124-1245
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 206-622-7747
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 206-467-1470
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 1001 SW KLICKITAT WAY
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Seattle
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Washington
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 98134-1161
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 206-622-7747
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 206-467-1470
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 11/18/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 04/15/2010
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 207ZD0900X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy.
Healthcare Provider Taxonomy #1
Provider License Number 1 MD00039332
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 WA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 207ZP0102X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Healthcare Provider Taxonomy #2
Provider License Number 2 MD00039332
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2 WA
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.