William R Shepard, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20A16448 Issued in CA

Practice address

1139 3Rd St
South Lake Tahoe, CA 96150

Phone

(530) 543-5691

Fax

(530) 542-2872

NPI assigned

Jun 12, 2012

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

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

General Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Merit-based Incentive Payment System (MIPS)

Final score

98.59 of 100Reported as group

Quality

95.23

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.71 of 100Reported as apm

Quality

89.85

Promoting interoperability

94.05

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wshepard136275@direct.renown.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.

• Barton Medical Foundation

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1750950499
  Medicare reassignment Care Compare group NPD
• Barton Healthcare System

  • Internal Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1235196015

  Surgery

  Medicare reassignment NPD
• Tahoe Carson Valley Medical Group Inc

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1508865528
  Medicare reassignment
• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  NPD (past)

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

• Barton Healthcare System

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1427310895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 3RD ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "530-543-5691",
            "fax_number": "530-542-2872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 NW 22nd Ave Ste 520",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103097",
            "country_code": "US",
            "telephone_number": "503-413-7557",
            "fax_number": "503-413-6547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "DO2454",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A16448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Dee Scofield
• Chiara Shari Sene
• Shelby Elizabeth Sgamma
• Mary Kelly Shanahan, MD
• Jamie Sheets
• Heather Lynn Shook
• Brett Erica Sibley, PA-C
• Kerstin Manderson Sidney, LCSW
• Sierra Child & Family Services
• Sierra Family Care Inc

• Surgery Physician in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.