Active NPI
Daniel Shuder, PA-C
- Physician Assistant
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3824
- Practice address
- 3003 W Good Hope Rd
Milwaukee, WI 53209 - Phone
- (414) 352-3100
- NPI assigned
- Aug 6, 2016
- Last updated
- Nov 22, 2021
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3824-23 | WI | |
| Physician Assistant | 363A00000X | 3824 | WI | Primary |
Addresses
Primary practice location
3003 W Good Hope Rd
Milwaukee, WI 53209
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other practice location 1
12219 W Verona Ct
West Allis, WI 53227-3880
Phone (414) 254-8201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100062895 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dshuder192897@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11550 University Blvd
Orlando, FL 32817-2100
Phone (407) 384-0080
2301 Sand Lake Rd
Orlando, FL 32809-7639
Phone (407) 851-6478
2609 S Orange Ave
Orlando, FL 32806-4547
Phone (407) 203-0656
440 W Hwy 436
Adventhealth Centra Care Altamonte
Altamonte Springs, FL 32714-4136
Phone (407) 788-2000
4660 13TH St
Saint Cloud, FL 34769-6765
Phone (321) 805-4650
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3824 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Medical Clinic, LLC | Current | Accepting new patients | |
| Adventist Health System/Sunbelt, Inc. | Physician Assistant | Current | Accepting new patients |
| Aurora Advanced Healthcare, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Adventist Health System/ Sunbelt, Inc. | Physician Assistant | Current | Accepting new patients |
| Aurora Advanced Healthcare Inc | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
Interoperability endpoints
- dshuder5043282@adventhealth.direct-ci.com
Organizations & group practices 9
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.
-
dba AdventHealth Centra Care
- Urgent Care Clinic/Center
- Maitland, FL
- NPI 1073565610
-
- Family Medicine Physician
- Milwaukee, WI
- NPI 1265629133
-
- Family Medicine Physician
- St Francis, WI
- NPI 1003861188
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
dba AdventHealth Centra Care - Southern Trace
- Urgent Care Clinic/Center
- The Villages, FL
- NPI 1396605440
Physician Assistant
-
dba AdventHealth Centra Care -KIds Winter Park
- Urgent Care Clinic/Center
- Winter Park, FL
- NPI 1194122200
Physician Assistant
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1467906529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53209",
"telephone_number": "414-352-3100"
}
],
"practiceLocations": [
{
"address_1": "12219 W Verona Ct",
"address_purpose": "LOCATION",
"city": "West Allis",
"state": "WI",
"postal_code": "532273880",
"country_code": "US",
"telephone_number": "414-254-8201",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHUDER",
"first_name": "DANIEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-06",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "3824-23",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3824",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100062895",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dshuder192897@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3003 W Good Hope Rd",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "53209",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "3003 W Good Hope Rd",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "53209",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.