DR. SHADY HENIEN (M.D.) – Interventional Cardiology Physician, NPI 1760820930

DR. SHADY HENIEN (M.D.) is a healthcare provider. based in Crestview, Florida. specializing in INTERVENTIONAL CARDIOLOGY, CARDIOVASCULAR DISEASE (CARDIOLOGY). They hold the professional credentials M.D.. They hold a License No. MD15478 (RI). The NPI Number for DR. SHADY HENIEN (M.D.) is 1760820930

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHADY HENIEN (M.D.)
NPI
1760820930
Phone
(217) 492-9115
Address
129 E REDSTONE AVE
Enumeration Date
11 June 2013
Last Update Date
26 August 2021

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
8506827212
Graduation Year
2013 (13 years ago)
PAC ID
6103111224
Group Practice PAC ID
7315920899
Professional Enrollment ID
I20210903000671
Address ID
FL325395350CR129XXAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:12State licenses:2Digital endpointsOther names

46 INTERVENTIONAL CARDIOLOGY in RI

Provider Addresses for DR. SHADY HENIEN (M.D.)

  • 129 E REDSTONE AVE

    STE A

    CRESTVIEW, FL 325395350

    Phone: (217) 492-9115

    Fax: (217) 522-1206

    Type: Mailing

  • 593 Eddy St

    APC814

    Providence, RI 029034923

    Phone: (401) 444-8689

    Type: Location

  • 800 E CARPENTER ST # 62

    SPRINGFIELD, IL 627691000

    Phone: (217) 492-9115

    Fax: (217) 522-1206

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 115 Open Payments records for all available years, with a total value of $7,583.

Total Amount is formed as General ($7,583) + Research ($0) + Ownership ($0) = $7,583.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Penumbra, Inc. ($2,596).

Total Amount

$7,583

General + Research + Ownership

Payments

115

Total payment records

General Amount

$7,583

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

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: 2021-09-03

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
I20210903000671IInterventional CardiologyFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2,017969$0
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function1,6601,622$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report677604$0
J2785Injection, regadenoson, 0.1 mg416104$0
99204New patient office or other outpatient visit, 45-59 minutes308308$0
View full utilization report →

Insurance plans in this area (ZIP 32539)

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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: 7315920899View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL
Cardiovascular Disease (Cardiology), Internal MedicineFL
-FL
Cardiovascular Disease (Cardiology)FL
Cardiovascular Disease (Cardiology)OH
Cardiovascular Disease (Cardiology)FL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal MedicineFL

Reviews

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Frequently asked questions

What NPI should I save for DR. SHADY HENIEN (M.D.)?
Save NPI 1760820930 if you need a stable reference for DR. SHADY HENIEN (M.D.).
Is DR. SHADY HENIEN (M.D.)'s NPI currently valid?
The extract we use shows DR. SHADY HENIEN (M.D.) as active.
What kind of provider is DR. SHADY HENIEN (M.D.)?
The page reflects Interventional Cardiology Physician for DR. SHADY HENIEN (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for DR. SHADY HENIEN (M.D.)?
We surface Crestview, Florida for DR. SHADY HENIEN (M.D.) based on available NPPES addresses.
What if Crestview, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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