SHABNAM SAMSUDDIN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1326591397
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SHABNAM SAMSUDDIN (CRNA)
PO BOX 551420
FORT LAUDERDALE, FL 333551420
Phone: (800) 243-3839
Fax: (855) 851-4405
Type: Mailing
845 CONSTELLATION DR
DECATUR, GA 300332814
Phone: (404) 642-5728
Type: Mailing
Gwinnett Medical Center, 1000, Medical Center Boulevard, Lawrenceville, Gwinnett County, Georgia, 30046, United States
LAWRENCEVILLE, GA 300467694
Phone: (770) 277-3056
Fax: (855) 204-5244
Type: Location
1133 EAGLES LANDING PKWY
STOCKBRIDGE, GA 302815085
Phone: (678) 604-1053
Type: Location
1100 JOHNSON FERRY RD
BLDG 2, UNIT 593
ATLANTA, GA 303421733
Phone: (404) 255-9096
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $338.
Total Amount is formed as General ($338) + Research ($0) + Ownership ($0) = $338.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($100).
Total Amount
$338
General + Research + Ownership
Payments
16
Total payment records
General Amount
$338
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2016-10-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161011000298 | I | Certified Registered Nurse Anesthetist (Crna) | GA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 23 | 23 | $0 |
Insurance plans in this area (ZIP 33355)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA |
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