Sharonda A Shaw-Berrocal, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS15645 Issued in FL

Practice address

31 W 155TH St
Harvey, IL 60426-3556

Phone

(630) 697-2601

Fax

(708) 589-2084

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Sharonda A Shaw Other name

Medicare fee-for-service enrollment

Enrolled in FL, KY2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center at Russellville Hospital, Russellville, KY, CCN 180066
• The Medical Center at Albany Hospital, Albany, KY, CCN 181333
• Caverna Memorial Hospital Hospital, Horse Cave, KY, CCN 181314
• The Medical Center at Scottsville Hospital, Scottsville, KY, CCN 181324
• The Medical Center at Franklin Hospital, Franklin, KY, CCN 181318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• Shi Keys LLC

  • Emergency Medicine Physician
  • Tavernier, FL
  • NPI 1952903536
  Medicare reassignment NPD
• Small Hospital Innovations LLC

  • Emergency Medicine Physician
  • Clewiston, FL
  • NPI 1184040560
  Medicare reassignment NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  NPD
• Fort Wayne Medical Education Program

  dba The Family Medicine Center

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1184635153
  NPD (past)

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

• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center at Russellville

  • Rural Acute Care Hospital
  • Russellville, KY
  • NPI 1124868963
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center at Caverna

  • Critical Access Hospital
  • Horse Cave, KY
  • NPI 1356716575
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center at Albany

  • Critical Access Hospital
  • Albany, KY
  • NPI 1598125502
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center at Scottsville

  • Critical Access Hospital
  • Scottsville, KY
  • NPI 1710906565
  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center at Franklin

  • Critical Access Hospital
  • Franklin, KY
  • NPI 1831173467
  Care Compare affiliation

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1417156274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-589-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "630-697-2601",
            "fax_number": "708-589-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW-BERROCAL",
        "first_name": "SHARONDA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-126062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003385A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS15645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARONDA",
            "last_name": "SHAW",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Scottlab, LTD.
• Maya Rae Searcy
• Serenity Haven Care NFP
• Nazila Shafagati, MD
• Shankar C Sanwalani MD and Associates
• Kimberly Danielle Shaw, PA-C
• Sheth Sushil a MD SC
• Sushil A Sheth, MD
• Robert Singh, MD
• Trina Sircar, DO

• Emergency Medicine Physician in Harvey, IL
• Providers in Harvey, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.