NPIMap

Individual provider Active NPI

Thomas Bart Shaw, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbia, MO
National Provider Identifier
1013966399
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD101288 Issued in MO
Practice address
300 Portland St Ste 110
Columbia, MO 65201-7390
Phone
(573) 886-4600
Fax
(573) 886-4695
NPI assigned
May 6, 2006
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD101288 MO Primary

Addresses

Primary practice location

300 Portland St Ste 110
Columbia, MO 65201-7390

Mailing address

300 Portland St Ste 110
Columbia, MO 65201-7390
Phone (573) 886-4600

Other identifiers 2

IdentifierTypeStateIssuer
11954768OtherCAQH
209661404MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000034 MO Practitioner - Pathology 0749452860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Missouri, Columbia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boyce and Bynum Pathology Professional Services IncGroup PAC ID 0042384976, 15 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone 57388646004608

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone 57388646004608

601 E 14TH St
Sedalia, MO 65301-5972
Phone 57388646004608

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
75.56
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD101288MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Mar 1, 2026 Accepting new patients
Curators of the University of Missouri CurrentSince Mar 1, 2026 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

200 Portland St
Columbia, MO 65201
Phone (573) 886-4600

300 Portland St
Ste 110
Columbia, MO 65201
Phone (573) 882-6081

800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1013966399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PORTLAND ST STE 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017390",
            "telephone_number": "573-886-4600",
            "fax_number": "573-886-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PORTLAND ST STE 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017390",
            "telephone_number": "573-886-4600",
            "fax_number": "573-886-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "THOMAS",
        "middle_name": "BART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "MD101288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11954768",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209661404",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.