Individual provider Active NPI

Dustin Lee Shawcross, MD

  • Emergency Medicine Physician
  • Federal Way, WA
National Provider Identifier
1043399975
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60062980 Issued in WA
Practice address
505 S 336TH St
Suite 600
Federal Way, WA 98003-5947
Phone
(800) 336-8614
Fax
(253) 838-6418
NPI assigned
Nov 2, 2006
Last updated
Sep 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X MD25749 OR
Emergency Medicine Physician 207P00000X MD60062980 WA Primary

Addresses

Primary practice location

505 S 336TH St
Suite 600
Federal Way, WA 98003-5947

Mailing address

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 530-2100

Other identifiers 8

IdentifierTypeStateIssuer
1008SHOtherWABSWA
1044SHOtherWABSWA
P00775117OtherWARRGA
8951562OtherWAVCR
0246652OtherWALIWA
0249327OtherWALIWA
0249327OtherWAVCR
8537680MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090319000611 WA Practitioner - Emergency Medicine 6002997350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 530-2100

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 627-4101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.32 of 100Reported as individual
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25749ORMDPersonal Emergency Response Attendant
MD60062980WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Mar 17, 2009 Accepting new patients
Tacoma Emergency Medicine Associates PC Emergency Medicine Past Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine Past Accepting new patients

Locations

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 396-6700

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: dshawcross9959@fhsce.catholichealth.net

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1043399975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11567 CANTERWOOD BLVD NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325812",
            "telephone_number": "253-530-2100",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035947",
            "telephone_number": "800-336-8614",
            "fax_number": "253-838-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWCROSS",
        "first_name": "DUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "OR",
            "license": "MD25749",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60062980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1008SH",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1044SH",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRGA",
            "identifier": "P00775117",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VCR",
            "identifier": "8951562",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0246652",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0249327",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VCR",
            "identifier": "0249327",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8537680",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.