Shaye Dostal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8709-023 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 805-8710

Fax

(414) 955-0115

NPI assigned

Nov 5, 2025

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

Other names 1

• Shaye Smith Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Midwestern University, Chicago College of Osteopathic Med, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Sports and Interventional Spine SCGroup PAC ID 8325447170, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Midwest Sports and Interventional Spine SC

  • Interventional Pain Medicine Physician
  • Kenosha, WI
  • NPI 1831770510
  Medicare reassignment Care Compare group NPD
• Midwest Sports and Interventional Spine SC

  • Interventional Pain Medicine Physician
  • Lake Geneva, WI
  • NPI 1740154947
  NPD

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1104796234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8710",
            "fax_number": "414-955-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8710",
            "fax_number": "414-955-0115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 76th St",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581984",
            "country_code": "US",
            "telephone_number": "262-577-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOSTAL",
        "first_name": "SHAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-05",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8709-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104796234",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYE",
            "last_name": "SMITH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.