Kerry Kathleen Shaughnessy, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME126538 Issued in FL

Practice address

600 Village Square Xing
Palm Beach Gardens, FL 33410-4543

Phone

(561) 693-0540

Fax

(561) 296-6174

NPI assigned

Apr 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Dermatology

Education

Eastern Virginia Medical School, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kshaughnessy@aquadermatology.emadirect.md

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.

• Aqua Dermatology of Florida, PA

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1538270335
  Medicare reassignment Care Compare group NPD
• Water'S Edge Dermatology, LLC

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1134148992
  Medicare reassignment NPD
• Naples Center for Dermatology & Riverchase Dermatology

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1538645775
  NPD
• Water'S Edge Dermatology, LLC

  • Clinical Medical Laboratory
  • Palm Beach Gardens, FL
  • NPI 1871542787
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1336438753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104543",
            "telephone_number": "561-693-0540",
            "fax_number": "561-296-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104543",
            "telephone_number": "561-693-0540",
            "fax_number": "561-296-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "KERRY",
        "middle_name": "KATHLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME126538",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME126538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshaughnessy@directaddress.net",
            "affiliation": "N",
            "address_1": "600 Village Square Xing",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334104543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Neha Shaik, M.D.
• Connie Denise Shannon-Evans, LCSW, ACSW, MSW
• Shapiro and Borenstein Dermatology LLP
• Evan R Shapiro, MD
• Steven David Shapiro, MD
• Jonathan Shaw, MD
• Stephanie Shaya
• Nicole Grace Sheehan
• Lawrence Shefter, D.O.
• Sheila Sherbert Inc.

• MOHS-Micrographic Surgery Physician in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.