John W Shore, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

F2001 Issued in TX

Practice address

3705 Medical Pkwy
Suite 120
Austin, TX 78705-1019

Phone

(512) 458-2141

Fax

(512) 458-4824

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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.

• University of Texas at Austin Dell Medical School

  • General Practice Physician
  • Austin, TX
  • NPI 1073066239
  Medicare reassignment NPD
• The University of Texas at Austin

  • General Practice Physician
  • Austin, TX
  • NPI 1073032546
  NPD
• University of Texas at Austin Dell Medical School

  • Ambulatory Surgical Clinic/Center
  • Austin, TX
  • NPI 1780218305
  NPD

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1194716035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY",
            "address_2": "SUITE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051019",
            "telephone_number": "512-458-2141",
            "fax_number": "512-458-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY",
            "address_2": "SUITE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051019",
            "telephone_number": "512-458-2141",
            "fax_number": "512-458-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F2001",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "F2001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124724903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Shook, LMFT
• Lynley A Shook, DDS
• Rachel Shook, LCSW
• Tara Shooshani, MD
• John Patrick Shope, DO
• Juliane Taylor Shore, LPC, LMFTA
• Taylor Shore
• Chelsea Taylor Short, PA-C
• Joan Marie Short, MS, LPC
• Tammy Short, MA, LPC, NCC

• Ophthalmic Plastic and Reconstructive Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.