NPIMap

Individual provider Active NPI

Neil T Shaw, DPM

  • Podiatrist
  • Saint Clair Shores, MI
National Provider Identifier
1144267758
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001895 Issued in MI
Practice address
27593 Harper
Saint Clair Shores, MI 48081
Phone
(586) 779-6140
Fax
(586) 779-9865
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001895 MI Primary

Addresses

Primary practice location

27593 Harper
Saint Clair Shores, MI 48081

Mailing address

27593 Harper
Saint Clair Shores, MI 48081
Phone (586) 779-6140

Other identifiers 2

IdentifierTypeStateIssuer
4532888MedicaidMI
4855010390OtherMIBLUE CROOS PIN NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000502 MI Practitioner - Podiatry 5890729982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anthony V Benenati DPM PCGroup PAC ID 8820021975, 4 clinicians
Complete Care Rehab LLCGroup PAC ID 2466423637, 12 clinicians

Practice addresses (Care Compare)

11800 E 12 Mile Rd
St John Macomb Oakland Hospital
Warren, MI 48093-3472
Phone (586) 573-5000

27593 Harper Ave
Saint Clair Shores, MI 48081-1923

31370 Harper Ave
Saint Clair Shores, MI 48082-2450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue28
Removal of skin lesions15
Removal of nail tissue1242
Removal or shaving of skin growth224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony V Benenati DPM PC Podiatrist CurrentSince Oct 1, 2005 Accepting new patients

Locations

46591 Romeo Plank Rd
Ste 104
Macomb, MI 48044
Phone (586) 416-3668

27593 Harper Ave
St Clr Shores, MI 48081
Phone (586) 779-6140

26440 Hoover Rd
Ste B
Warren, MI 48089
Phone (586) 756-3338

Interoperability endpoints

  • Direct secure messaging: nshaw60484@direct.hfhs.org

Organizations & group practices 2

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 7

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1144267758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27593 HARPER",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-779-6140",
            "fax_number": "586-779-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27593 HARPER",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-779-6140",
            "fax_number": "586-779-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "NEIL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4532888",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROOS PIN NUMBER",
            "identifier": "4855010390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.