Kanwon Shaw, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9339 Issued in MA

Practice address

1 Cabot Rd Ste 101
Hudson, MA 01749-2963

Phone

(978) 562-3536

Fax

(978) 562-4626

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc Physicians of Massachusetts, PCGroup PAC ID 9234321308, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaw.kanwon.crm@direct.partners.masshiway.net

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.

• Afc Physicians of Massachusetts, PC

  • Urgent Care Clinic/Center
  • Springfield, MA
  • NPI 1902123276
  Medicare reassignment Care Compare group
• Charles River Medical Associates PC

  • Internal Medicine Physician
  • Framingham, MA
  • NPI 1598215204
  Medicare reassignment NPD
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Kablotsky Internal Medicine PLLC

  • Internal Medicine Physician
  • Hudson, MA
  • NPI 1841096815
  Medicare reassignment
• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment
• Afc Physicians of Massachusetts, PC

  • Urgent Care Clinic/Center
  • Natick, MA
  • NPI 1114293917
  NPD
• Charles River Medical Associates PC

  • Sports Medicine (Internal Medicine) Physician
  • Northborough, MA
  • NPI 1710495585
  NPD

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

• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1477170546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 203B",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211187",
            "telephone_number": "508-881-3029",
            "fax_number": "508-881-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CABOT RD STE 101",
            "city": "HUDSON",
            "state": "MA",
            "postal_code": "017492963",
            "telephone_number": "978-562-3536",
            "fax_number": "978-562-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KANWON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "PA9338",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shaw.Kanwon.CRM@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Cabot Rd Ste 101",
            "city": "Hudson",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017492963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Schofield
• Danielle Scipione
• Susan Ellen Scripter
• Lais Ayres Seixas-Oliveira
• Mike Seldon
• Richard T Sheehan, PT, DPT
• Rachel Sherman
• Julia Sherwood, LMHC
• Lorena Silva, MA
• Elisabeth Small

• Physician Assistant in Hudson, MA
• Providers in Hudson, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.