Individual provider Active NPI

Shawn Tittle, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Baytown, TX
National Provider Identifier
1396778601
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
R0798 Issued in TX
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

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001427774MedicaidCT
8GK557OtherTXBCBS

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

LicenseStateTypeSpecialty
042777CTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.