Individual provider Active NPI

Patrick Shaw, PA-C

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1124903141
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
229 Trumbull St
Hartford, CT 06103-1501
Phone
(860) 231-5420
NPI assigned
Aug 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

229 Trumbull St
Hartford, CT 06103-1501

Mailing address

68 North St
Duxbury, MA 02332-2902
Phone (857) 340-9053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20251017001994 MA Practitioner - Physician Assistant 9133616576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Boston Urology LLC 44 clinicians

Practice addresses (Care Compare)

45 Home Depot Dr
Suite 100
Plymouth, MA 02360-2669
Phone (508) 732-6770

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gbu Bidco LLC Current Accepting new patients
Brockton Urology Clinic Inc Current Accepting new patients

Locations

161 Worcester Rd
Ste 602
Framingham, MA 01701
Phone (603) 479-4082

31 Roche Brothers Way
Ste 100
North Easton, MA 02356
Phone (508) 238-0800

45 Home Depot Dr
#100
Plymouth, MA 02360
Phone (508) 732-6770

Interoperability endpoints

  • Direct secure messaging: patrickshaw@gbu.medalliesdirect.net

Organizations & group practices 3

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 1

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": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1124903141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 NORTH ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023322902",
            "telephone_number": "857-340-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 TRUMBULL ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061031501",
            "telephone_number": "860-231-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.