Shawn D Fisher, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9113659 Issued in FL

Practice address

6666 Bali Hai Drive
BB, FL 33437

Phone

(888) 789-6672

Fax

(646) 862-9066

NPI assigned

May 1, 2017

Last updated

May 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Treasure Coast Medical AssociatesGroup PAC ID 6608768122, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawn.fisher.1@25843.direct.athenahealth.com

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.

• Treasure Coast Medical Associates

  dba Stuart Urgent Care

  • Emergency Medicine Physician
  • Jensen Beach, FL
  • NPI 1992791198
  Medicare reassignment Care Compare group NPD
• Mental Health Now LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Boynton Beach, FL
  • NPI 1295422442
  NPD Authorized official
• 5 Borough Anesthesia, PLLC

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1811138365
  NPD (past)
• New York Pain Management Group, PLLC

  • Pain Medicine Physician
  • Bronx, NY
  • NPI 1295845220
  NPD (past)
• The Rye Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Rye, NY
  • NPI 1578892600
  NPD (past)

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1053846774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6666 BALI HAI DR.",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "888-789-6672",
            "fax_number": "646-862-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6666 BALI HAI DRIVE",
            "city": "BB",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "888-789-6672",
            "fax_number": "646-862-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SHAWN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0053071",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.

Verify at the official NPI Registry.