Amy Elizabeth Shaw, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G69999 Issued in CA

Practice address

121 Sotoyome Street
Santa Rosa, CA 95405-4823

Phone

(707) 546-4062

Fax

(707) 525-8067

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashaw1658288@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Munro, Booth & Cutruzzola

  dba Sonoma Imaging Medical Associates

  • Diagnostic Radiology Physician
  • Healdsburg, CA
  • NPI 1437103884
  NPD (past)
• North Coast Faculty Medical Group Inc

  dba Sutter Medical Group of the Redwoods

  • Otolaryngology Physician
  • Sebastopol, CA
  • NPI 1750616512
  NPD (past)
• Redwood Regional Medical Group Inc

  • Hematology & Oncology Physician
  • Santa Rosa, CA
  • NPI 1275556607
  NPD (past)
• Redwood Regional Medical Group, Inc.

  dba Redwood Regional Oncology Center

  • Clinical Medical Laboratory
  • Santa Rosa, CA
  • NPI 1588743264
  NPD (past)
• Sutter Medical Center of Santa Rosa

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1700855756
  NPD (past)

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

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Care Compare affiliation

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1427127588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SOTOYOME STREET",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054823",
            "telephone_number": "707-546-4062",
            "fax_number": "707-525-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SOTOYOME STREET",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054823",
            "telephone_number": "707-546-4062",
            "fax_number": "707-525-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G699990",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashaw1658288@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "121 Sotoyome Street",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paula D Shatkin, LCSW
• Tess Shatto
• Paula Lee Shaul, MFT
• Julia Mary Shaver, MD
• Wendy Shaw-Lyons, LCSW
• Emily Shaw, M.D.
• Emma Shaw
• Gary Thomas Shaw, M.D.
• Ron E. Shaw
• Aidan Shea

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.