Kenneth Alan Shore, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G6231 Issued in TX

Practice address

5501 Independence Pkwy Ste 110
Plano, TX 75023-5472

Phone

(972) 596-1747

Fax

(972) 985-9775

NPI assigned

Jun 13, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Internal Medicine

Education

Eastern Virginia Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Clinic of North Texas, PLLCGroup PAC ID 9830084540, 212 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651
• Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.shore@wellmed.eclinicaldirectplus.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1033167234
  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc.

  • Physical Therapist
  • Cedar Park, TX
  • NPI 1871132357
  Care Compare group
• Medical Clinic of North Texas PLLC

  • Radiation Oncology Clinic/Center
  • Arlington, TX
  • NPI 1184131625
  NPD
• Medical Clinic of North Texas, PLLC

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1912955030
  NPD

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

• Baylor Regional Medical Center at Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1649273434
  Care Compare affiliation
• Columbia Medical Center of Plano Subsidiary LP

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1114960606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 INDEPENDENCE PKWY STE 110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235472",
            "telephone_number": "972-596-1747",
            "fax_number": "972-985-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 INDEPENDENCE PKWY STE 110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235472",
            "telephone_number": "972-596-1747",
            "fax_number": "972-985-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G6231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098591301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098591303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Shivers, PA-C
• Sarika Bhatnagar Shivnani, MD
• Rebecca Ellen Shmukler, OTR/L
• Mark Shoemaker II
• Stephanie Clare Shoemaker, OT/L, CKTP
• Mary Shorney, MS, RD, LD, CDE
• Michael Christopher Short, MD
• Katelyn Shortes
• Riley Shoubash, LPC
• Theresa A Shouse, M.D.

• Internal Medicine Physician in Plano, TX
• Providers in Plano, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.