Active NPI
Shawn Thomas Gaughan, CRNA
- Certified Registered Nurse Anesthetist
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN223809
- Practice address
- 1544 Sheldon St
Saint Paul, MN 55108-2331 - Phone
- (651) 646-3091
- Fax
- (651) 646-3124
- NPI assigned
- Mar 15, 2006
- Last updated
- Jun 14, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R 139202-1 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | RN223809 | MA | Primary |
Addresses
Primary practice location
1544 Sheldon St
Saint Paul, MN 55108-2331
Mailing address
1544 Sheldon St
Saint Paul, MN 55108-2331
Phone (651) 646-3091
Other practice location 1
41 Mall Rd
Burlington, MA 01805-2331
Phone (781) 744-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 985190900 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lahey Clinic Inc
Practice addresses (Care Compare)
1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000
29 Mall Rd
Burlington, MA 01805-0001
41 Mall Rd
Burlington, MA 01805-0001
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.98 of 100
- Quality
- 76.59
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN223809 | MA | MD | Certified Registered Nurse Anesthetist |
| R 139202-1 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lahey Clinic, Inc | Current | Accepting new patients | |
| Beverly Anesthesia Associates, Inc. | Current | Accepting new patients | |
| Lahey Clinic, Inc. | Current | Accepting new patients |
Locations
85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700
41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400
480 Maple St
Danvers, MA 01923
Phone (978) 304-8380
480 Maple St
Ste C233A
Danvers, MA 01923
Phone (978) 304-8690
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Danvers, MA
- NPI 1427041268
-
- Internal Medicine Physician
- Peabody, MA
- NPI 1063447316
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Burlington, MA
- NPI 1558392563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1417926130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1544 SHELDON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551082331",
"telephone_number": "651-646-3091",
"fax_number": "651-646-3124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1544 SHELDON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551082331",
"telephone_number": "651-646-3091",
"fax_number": "651-646-3124"
}
],
"practiceLocations": [
{
"address_1": "41 Mall Rd",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018052331",
"country_code": "US",
"telephone_number": "781-744-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAUGHAN",
"first_name": "SHAWN",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R 139202-1",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "RN223809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "985190900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.