NPIMap

Individual provider Active NPI

Michael Shaw, DO

  • Internal Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1295010148
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8671031 Issued in ID
Practice address
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone
(208) 814-4100
Fax
(208) 814-4908
NPI assigned
Oct 11, 2011
Last updated
May 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8671031 ID Primary
Internal Medicine Physician 207R00000X DO-06846 IA
Hospitalist Physician 208M00000X DO-06846 IA

Addresses

Primary practice location

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

4101 Woolworth Ave
Omaha, NE 68105-1850
Phone (402) 346-8800 ext. 5326

Other practice location 2

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20260330002179 ID Practitioner - Internal Medicine 1254686900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1720

801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-06846IAMDInternal Medicine Physician
8671031IDMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mshaw412668@direct.nebraskamed.com

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 5

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1295010148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 POLE LINE RD W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015810",
            "telephone_number": "208-814-4100",
            "fax_number": "208-814-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 Woolworth Ave",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681051850",
            "country_code": "US",
            "telephone_number": "402-346-8800 x5326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-4019",
            "fax_number": "319-353-8073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "8671031",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "DO-06846",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "DO-06846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.