Kathleen A Shallow, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35968-020 Issued in WI

Practice address

10625 W North Ave
102
Milwaukee, WI 53226-2315

Phone

(414) 877-5350

Fax

(414) 877-5360

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Emergency Medicine

Education

Medical College of Wisconsin, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Ascension Wisconsin Hosp Menomonee Falls Campus Hospital, Menomonee Falls, WI, CCN 520214

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Medicine Specialists, S.C.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1568413524
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)
• Integrated Therapeutic Massage LLC

  • Massage Therapist
  • Milwaukee, WI
  • NPI 1144994096
  NPD (past)

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

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension St Francis Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1225087190
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Menomonee Falls, WI
  • NPI 1063018927
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1225635592
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255938510
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1063433837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLOW",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "35968-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32179700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nosheen N Shaikh, MD
• Reza Shaker, MD
• Sameer Shakir, MD
• Shalem Healing, Inc.
• Michael Joseph Shallcross, MD
• Natasha Rae Shallow, M.D.
• Shalom Health Center, SC
• Shalonda Booth
• Sham Chandok
• Corey Justin Shamah, M.D.

• Emergency Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.