Frederick C. Shaw, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

94683 Issued in NY

Practice address

450 Margaret St
Plattsburgh, NY 12901-1755

Phone

(518) 566-2020

Fax

(518) 561-5390

NPI assigned

Dec 18, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1477737096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011755",
            "telephone_number": "518-566-2020",
            "fax_number": "518-561-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011755",
            "telephone_number": "518-566-2020",
            "fax_number": "518-561-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "FREDERICK",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "94683",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA021193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02966654",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD/TRAVELERS' MEDICARE",
            "identifier": "P00624541",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lynne Marie Sheehan
• Jeffrey S Shelby, MD
• Thomas Shelton, MD
• Linda Diane Shepard, DDS

• Ophthalmology Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.