Joseph Jacob Shaffer, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

42452 Issued in MN

Practice address

1215 Town Centre Dr
Suite 200
Eagan, MN 55123-1033

Phone

(651) 255-3300

Fax

(651) 255-3450

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Dermatology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Consultants, PAGroup PAC ID 1850295676, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.99 of 100Reported as group

Quality

61.48

Promoting interoperability

93

Improvement activities

40

Cost

77.67

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshaffer@dermcons.encitedirect.com

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.

• Dermatology Consultants, PA

  • Dermatology Physician
  • Woodbury, MN
  • NPI 1568567139
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1427167691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PLATO BLVD E",
            "address_2": "SUITE 270",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071827",
            "telephone_number": "651-209-1600",
            "fax_number": "651-291-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 TOWN CENTRE DR",
            "address_2": "SUITE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231033",
            "telephone_number": "651-255-3300",
            "fax_number": "651-255-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "JOSEPH",
        "middle_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "42452",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MN",
            "license": "42452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061605200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenity Support Services LLC
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• Rashidah Shabazz
• Angela Marie Shade, PHARM.D
• Kristina Kelly Shaffer, M.D.
• Maryam Shah Din
• Abdulrahman Sharif
• Kristina Sharma
• Neha Sharma, MD

• MOHS-Micrographic Surgery Physician in Eagan, MN
• Providers in Eagan, MN by specialty
• MOHS-Micrographic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.