Individual provider Active NPI

Shaw J Mahre, PA-C

  • Surgical Physician Assistant
  • Chandler, AZ
National Provider Identifier
1053050237
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9315 Issued in AZ
Practice address
1455 W Chandler Blvd BLDG B #8
Chandler, AZ 85224-6177
Phone
(480) 899-1696
Fax
(480) 963-6227
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Physician Assistant 363AS0400X 9315 AZ Primary

Addresses

Primary practice location

1455 W Chandler Blvd BLDG B #8
Chandler, AZ 85224-6177

Mailing address

PO Box 6423
Chandler, AZ 85246-6423
Phone (480) 821-2838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025002175 AZ Practitioner - Physician Assistant 8921474404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

6111 E Arbor Ave
Mesa, AZ 85206-6059
Phone (480) 981-1326

690 E Warner Rd
BLDG 5
Gilbert, AZ 85296-3054
Phone (480) 664-0261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.11 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9315AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC CurrentSince Aug 24, 2024 Accepting new patients

Locations

1455 W Chandler Blvd
Ste B8
Chandler, AZ 85224
Phone (480) 899-1696

1455 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 899-2900

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBEDBD/Endpoint/BBEDBD

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1053050237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423",
            "telephone_number": "480-821-2838",
            "fax_number": "480-821-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 W CHANDLER BLVD BLDG B #8",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246177",
            "telephone_number": "480-899-1696",
            "fax_number": "480-963-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHRE",
        "first_name": "SHAW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.