NPIMap

Individual provider Active NPI

Jerod K Shaw, MD

  • Pain Medicine Physician
  • Marble Falls, TX
National Provider Identifier
1407030836
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
N6015 Issued in TX
Practice address
511 US Highway 281
Marble Falls, TX 78654-5708
Phone
(830) 992-2850
NPI assigned
Dec 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X N6015 TX
Pain Medicine Physician 208VP0000X N6015 TX Primary

Addresses

Primary practice location

511 US Highway 281
Marble Falls, TX 78654-5708

Mailing address

205 W Windcrest St
Ste 130
Fredericksburg, TX 78624-4422
Phone (830) 990-6631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110714000681 TX Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 0941478119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Texas Medical Branch at Galveston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1005 Falls Pkwy
Suite 105
Marble Falls, TX 78654-4608
Phone (512) 588-9230

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.35 of 100Reported as individual
Quality
70.46
Promoting interoperability
92
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N6015TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shaw Pain Clinic PLLC Physical Medicine & Rehabilitation CurrentSince Jan 5, 2017 Accepting new patients
Central Texas Anesthesia Partners PLLC PastSince Jul 16, 2019 Accepting new patients
Consultants in Pain Medicine, PLLC Pain Medicine Past Accepting new patients

Locations

600 Jefferson St
Ste 404
Lafayette, LA 70501

1005 Falls Pkwy
Ste 105
Marble Falls, TX 78654
Phone (512) 588-9230

Interoperability endpoints

  • Direct secure messaging: jerod.shaw.1@20019.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20019/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 5

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": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1407030836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WINDCREST ST",
            "address_2": "STE 130",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244422",
            "telephone_number": "830-990-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 US HIGHWAY 281",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545708",
            "telephone_number": "830-992-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JEROD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-20",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "N6015",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "N6015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

Verify at the official NPI Registry.