Individual provider Active NPI

Roger Shen

  • Family Medicine Physician
  • Katy, TX
National Provider Identifier
1225472566
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R0499 Issued in TX
Practice address
22915 Morton Ranch Rd
Katy, TX 77449-2159
Phone
(281) 574-0124
NPI assigned
Apr 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R0499 TX Primary

Addresses

Primary practice location

22915 Morton Ranch Rd
Katy, TX 77449-2159

Mailing address

423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500

Other practice location 1

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

Other practice location 2

510 N Hewitt Dr
Hewitt, TX 76643-3038
Phone (254) 420-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240206000646 PA Practitioner - Family Practice 8921385170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2024 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2024 Accepting new patients
Urgent Care, PC - Pennsylvania Current Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Interoperability endpoints

  • Direct secure messaging: rshen38396@direct.optum.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1225472566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BLVD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081351",
            "telephone_number": "304-225-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22915 MORTON RANCH RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774492159",
            "telephone_number": "281-574-0124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Downing St",
            "address_purpose": "LOCATION",
            "city": "Tahlequah",
            "state": "OK",
            "postal_code": "744643324",
            "country_code": "US",
            "telephone_number": "918-456-0641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 N Hewitt Dr",
            "address_purpose": "LOCATION",
            "city": "Hewitt",
            "state": "TX",
            "postal_code": "766433038",
            "country_code": "US",
            "telephone_number": "254-420-5000",
            "fax_number": "254-420-5007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "ROGER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R0499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.