NPIMap

Individual provider Active NPI

Alan Gregory Shamrock, MD

  • Orthopaedic Surgery Physician
  • Green Bay, WI
National Provider Identifier
1376072819
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
84137-20 Issued in WI
Practice address
1726 Shawano Ave
Green Bay, WI 54303-3216
Phone
(920) 496-4700
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R-10836 IA
Orthopaedic Surgery Physician 207X00000X 84137-20 WI Primary

Addresses

Primary practice location

1726 Shawano Ave
Green Bay, WI 54303-3216

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
100288844MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashamrock453135@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240925000560 WI Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5698044238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84137-20WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Clare Memorial Hospital, Inc CurrentSince Sep 1, 2024 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Orthopaedic Surgery CurrentSince Sep 1, 2024 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 1, 2024 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 1, 2024 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 1, 2024 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: ashamrock453135@ewd.direct.hshs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1376072819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMROCK",
        "first_name": "ALAN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IA",
            "license": "R-10836",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "84137-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100288844",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashamrock453135@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1726 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.