Individual provider Active NPI

Shawn Tai, M.D.

  • Hematology & Oncology Physician
  • Athens, TX
National Provider Identifier
1306005798
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
R5044 Issued in TX
Practice address
115 Medical Cir Ste 106
Athens, TX 75751
Phone
(903) 675-1322
Fax
(903) 675-6743
NPI assigned
Jun 2, 2008
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X R5044 TX Primary

Addresses

Primary practice location

115 Medical Cir Ste 106
Athens, TX 75751

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7635

Other identifiers 5

IdentifierTypeStateIssuer
150833MedicaidAL
151223MedicaidAL
511-37500OtherALBCBS OF AL
511-38669OtherALBCBS OF AL
102G70337OtherALMEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171204000770 TX Practitioner - Hematology/Oncology 9537311600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 S Beckham Ave
Ut Health Science Center at Tyler
Tyler, TX 75701-1908
Phone (903) 877-7200

102 W Henderson St
Ut Health Northeast Overton
Overton, TX 75684-1613
Phone (903) 834-0201

115 Medical Cir
Suite 106
Athens, TX 75751-9004
Phone (903) 284-5024

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R5044TXMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Aug 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Aug 1, 2019 Accepting new patients

Locations

115 Medical Cir
Ste 106
Athens, TX 75751
Phone (903) 284-5024

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

721 Clinic Dr
Tyler, TX 75701
Phone (903) 535-6301

721 Clinic Dr
#A
Tyler, TX 75701
Phone (903) 592-6152

Interoperability endpoints

  • Direct secure messaging: stai355696@ahs.direct-ci.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 4

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1306005798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7635",
            "fax_number": "903-877-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 106",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "75751",
            "telephone_number": "903-675-1322",
            "fax_number": "903-675-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "SHAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "R5044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150833",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151223",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "511-37500",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "511-38669",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "102G70337",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

Verify at the official NPI Registry.