AMY WALL SHORE (M.D.) – Anesthesiology Physician, NPI 1235305566

AMY WALL SHORE (M.D.) is a healthcare provider. based in Manhattan beach, California. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. 226228 (MA). The NPI Number for AMY WALL SHORE (M.D.) is 1235305566

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
AMY WALL SHORE (M.D.)
NPI
1235305566
Phone
(310) 737-2844
Address
1590 ROSECRANS AVE STE D
Enumeration Date
6 May 2008
Last Update Date
15 November 2025

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Secondary Phone
3106657150
Graduation Year
2004 (22 years ago)
PAC ID
3072672906
Group Practice PAC ID
4183114028
Professional Enrollment ID
I20130125000191
Address ID
CA900459212LO6801XTERX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness85
Years active:18State licenses:3Digital endpointsOther names

6,371 ANESTHESIOLOGY in CA

Provider Addresses for AMY WALL SHORE (M.D.)

  • 1590 ROSECRANS AVE STE D

    MANHATTAN BEACH, CA 902663716

    Phone: (310) 737-2844

    Type: Mailing

  • 4553 GLENCOE AVE STE 100

    MARINA DEL REY, CA 902927917

    Phone: (949) 988-7800

    Type: Location

  • PO BOX 4148

    TORRANCE, CA 905104148

    Phone: (310) 792-3914

    Fax: (855) 898-4055

    Type: Mailing

  • 3445 PCH HWY STE 110

    TORRANCE, CA 905056659

    Phone: (617) 686-2647

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2024-09-24 • Largest payer in this snapshot: Curonix LLC ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Curonix LLC$25
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-01-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130125000191IAnesthesiologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90266)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183114028View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

What federal number belongs to AMY WALL SHORE (M.D.)?
The federal identifier for AMY WALL SHORE (M.D.) is NPI 1235305566.
Does this profile mean AMY WALL SHORE (M.D.) is currently active?
Yes — AMY WALL SHORE (M.D.) appears active in the national provider directory.
What kind of provider is AMY WALL SHORE (M.D.)?
The page reflects Anesthesiology Physician for AMY WALL SHORE (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for AMY WALL SHORE (M.D.)?
The page summarizes Manhattan Beach, California for AMY WALL SHORE (M.D.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.