SHUBA SAMUEL (FNP, PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1326324385
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for SHUBA SAMUEL (FNP, PMHNP)
325 E H ST
IRON MOUNTAIN, MI 498014760
Phone:
Type: Mailing
813 E LAKESHORE DR
MANISTIQUE, MI 49854
Phone: (906) 341-3420
Type: Location
7870W US Highway 2
Manistique, MI 498548992
Phone: (906) 341-3200
Type: Location
4650 S HOWELL AVE
MILWAUKEE, WI 532075908
Phone: (414) 376-5577
Type: Location
718 RANGE ST
MANISTIQUE, MI 498541644
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20111228000058 | I | Nurse Practitioner | WI | TBD |
| I20240105001665 | I | Nurse Practitioner | MI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | ND | |
| Nurse Practitioner | WI | |
| - | WI | |
| - | NV | |
| Nurse Practitioner | WI | |
| - | WI | |
| - | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI |
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