Active NPI
Brian E. O'Shaughnessy, MD
- Neurology Physician
- Waterloo, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 036-066709
- Practice address
- 152 W Dale St
Waterloo, IA 50703-1925 - Phone
- (319) 235-5060
- Fax
- (319) 235-5061
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036-066709 | IL | Primary |
Addresses
Primary practice location
152 W Dale St
Waterloo, IA 50703-1925
Mailing address
152 W Dale St
Waterloo, IA 50703-1925
Phone (319) 235-5060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036066709 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
152 W Dale St
Waterloo, IA 50703-1925
Phone (319) 235-5060
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-066709 | IL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Neurology | Current | Accepting new patients |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363
2140 Logan Ave
Ste B
Waterloo, IA 50703
Phone (319) 226-8470
152 W Dale St
Waterloo, IA 50703
Phone (319) 235-3540
1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886
Interoperability endpoints
- boshaughnessy386696@direct.unitypoint.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- West Des Moines, IA
- NPI 1366425274
Neurology
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Waterloo, IA
- NPI 1336231091
-
- General Acute Care Hospital
- Waterloo, IA
- NPI 1700827896
-
- Critical Access Hospital
- Grundy Center, IA
- NPI 1821055989
-
- Critical Access Hospital
- Independence, IA
- NPI 1265595144
-
- Critical Access Hospital
- Waverly, IA
- NPI 1447299953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1023021151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 W DALE ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031925",
"telephone_number": "319-235-5060",
"fax_number": "319-235-5061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 W DALE ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031925",
"telephone_number": "319-235-5060",
"fax_number": "319-235-5061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SHAUGHNESSY",
"first_name": "BRIAN",
"middle_name": "E.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036-066709",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036066709",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.