| Shira Tannenbaum, | |
|
1227 E Rusholme St, Davenport, IA 52803-2459 | |
| (563) 324-8160 | |
| (563) 324-8486 |
| Full Name | Shira Tannenbaum |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Experience | 15 Years |
| Location | 1227 E Rusholme St, Davenport, Iowa |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336467489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LC0200X | Anesthesiology - Critical Care Medicine | DO-04709 (Iowa) | Secondary |
| 207L00000X | Anesthesiology | DO-04709 (Iowa) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Genesis Medical Center-davenport | Davenport, IA | Hospital |
| Mercyone Dubuque Medical Center | Dubuque, IA | Hospital |
| Mercyone Clinton Medical Center | Clinton, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medical Associates Clinic P C | 3870491228 | 218 |
| Anesthesia And Analgesia Pc | 7810887627 | 20 |
| Mercy Clinton Anesthesia Group, Llc | 9537306394 | 8 |
| Entity Name | Medical Associates Clinic P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457300790 PECOS PAC ID: 3870491228 Enrollment ID: O20031223000311 |
| Entity Name | Anesthesia & Analgesia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558306381 PECOS PAC ID: 7810887627 Enrollment ID: O20040316001395 |
| Entity Name | Mercy Clinton Anesthesia Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184962862 PECOS PAC ID: 9537306394 Enrollment ID: O20130515000132 |
| Mailing Address | Practice Location Address |
|---|---|
| Shira Tannenbaum, Po Box 1245, Bettendorf, IA 52722-0021 Ph: (563) 324-8160 | Shira Tannenbaum, 1227 E Rusholme St, Davenport, IA 52803-2459 Ph: (563) 324-8160 |
Johanna Laidig, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1227 E Rusholme St, Davenport, IA 52803 Phone: 563-421-1000 | |
Mr. Ilya B Volfson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1227 E Rusholme St, Davenport, IA 52803 Phone: 563-421-1000 Fax: 563-421-7889 | |
Eunhea Kim, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1227 E Rusholme St, Davenport, IA 52803 Phone: 563-421-1000 | |
Dr. Stephen Thomas Delessio, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1227 East Rusholme Street, Davenport, IA 52803 Phone: 563-421-1000 Fax: 563-421-7889 | |
Mr. Johnny Edward Brian Jr., MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1227 E Rusholme St, Davenport, IA 52803 Phone: 563-421-1000 Fax: 563-421-7889 | |
Sara Fay Reader, DO, MS Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1227 E Rusholme St, Davenport, IA 52803 Phone: 563-421-1000 | |
Mr. Todd Jon Roehr, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1227 East Rusholme Street, Davenport, IA 52803 Phone: 563-421-1000 Fax: 563-421-7889 |