Active NPI
Shawn Tittle, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Baytown, TX
National Provider Identifier
1396778601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- R0798
- Practice address
- 4201 Garth Rd
Suite 211
Baytown, TX 77521-3167 - Phone
- (832) 556-6046
- Fax
- (281) 428-4720
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 042777 | CT | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 042777 | CT | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | R0798 | TX | Primary |
Addresses
Primary practice location
4201 Garth Rd
Suite 211
Baytown, TX 77521-3167
Mailing address
4201 Garth Rd
Suite 211
Baytown, TX 77521-3167
Phone (832) 556-6046
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001427774 | Medicaid | CT | |
| 8GK557 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042777 | CT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Hospitals at Niles and St Joseph, Inc | Past | Accepting new patients |
Interoperability endpoints
- stittle77943@directhoustonmethodist.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484524800000",
"number": "1396778601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 GARTH RD",
"address_2": "SUITE 211",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775213167",
"telephone_number": "832-556-6046",
"fax_number": "281-428-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 GARTH RD",
"address_2": "SUITE 211",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775213167",
"telephone_number": "832-556-6046",
"fax_number": "281-428-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITTLE",
"first_name": "SHAWN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2017-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "042777",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "CT",
"license": "042777",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "TX",
"license": "R0798",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001427774",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8GK557",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baytown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.