Individual provider Active NPI

Shaun Michael Nordeck, MD

  • Vascular & Interventional Radiology Physician
  • Lexington, KY
National Provider Identifier
1285122341
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
59690 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-1201
Phone
(859) 323-2222
Fax
(859) 323-5090
NPI assigned
Apr 24, 2018
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X BP20066772 TX
Vascular & Interventional Radiology Physician 2085R0204X 59690 KY Primary
Surgery Physician 208600000X BP10062891 TX

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-1201

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-9316
Phone (214) 648-7236

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-1201
Phone (214) 648-7236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240715003796 KY Practitioner - Diagnostic Radiology 3870841372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

800 Rose St
Lexington, KY 40536-0001
Phone (859) 323-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Surgery CurrentSince Jun 13, 2024 Accepting new patients
University of Kentucky CurrentSince Jun 13, 2024 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1285122341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909316",
            "telephone_number": "214-648-7236",
            "fax_number": "214-648-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361201",
            "telephone_number": "859-323-2222",
            "fax_number": "859-323-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753901201",
            "country_code": "US",
            "telephone_number": "214-648-7236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDECK",
        "first_name": "SHAUN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "BP20066772",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "59690",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10062891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.