Shay Hartvickson, M.D.
Individual provider Active NPI Emergency Medicine Physician · Fort Cavazos, TX
NPI 1477913747 · NPPES record last updated Aug 14, 2024
Key facts
- NPI
- 1477913747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 14729 (ND)
- Practice address
- 590 Medical Center Road
Fort Cavazos, TX 76544 - Phone
- (701) 208-1808
- NPI assigned
- Mar 1, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- University of North Dakota School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Em Alliance Texas PLLC
Bryan Emergency Physicians PA
Practice addresses (Care Compare)
1501 S Coulter St
NW TX Healthcare Sys
Amarillo, TX 79106-1770
Phone (561) 203-0611
2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (409) 986-7757
Hospital & facility affiliations
- CHI St Joseph Health Regional Hospital
- Northwest Texas Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240405001570 | TX | Practitioner - General Practice |
1052759370 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14729 | ND | MD | Emergency Medicine Physician |
| PT14729 | ND | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryan Emergency Physicians PA | Emergency Medicine | Current |
Accepting new patients |
| Nes Southwest Medical Services Inc | Emergency Medicine | Current |
Accepting new patients |
| Em Alliance Texas, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Acs Primary Care Physicians Southwest, PA | Emergency Medicine | Current |
Accepting new patients |
| Brazos Valley Emergency Physicians PA | Emergency Medicine | Current |
Accepting new patients |
Locations
4121 S Georgia St
Amarillo, TX 79110
Phone (561) 203-0611
1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150
4207 W Amarillo Blvd
Amarillo, TX 79106
Phone (806) 351-7850
8960 Hillside Rd
Amarillo, TX 79119
Phone (806) 351-6987
2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777
2901 4th St
Longview, TX 75605
Phone (281) 371-1800
210 S Judson St
Navasota, TX 77868
Phone (936) 825-6585
500 N Highland Ave
Sherman, TX 75092
Phone (903) 870-4494
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | PT14729 | ND | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 14729 | ND | Yes |
Addresses
Primary practice location
590 Medical Center Road
Fort Cavazos, TX 76544
Mailing address
590 Medical Center Rd.
Fort Cavazos, TX 76544
Phone (208) 208-1808
Other practice location 1
9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-0117
Other practice location 2
Building 7015 Murphy Loop
Hood Army Airfield
Fort Hood, TX 76544-1000
Phone (208) 208-1808
Other providers in Fort Cavazos, TX
- Dawn Deann Hallums
- Monique Yvette Hardy
- Brandon Fullerton Harris
- Justin Prescott Harris
- Lisa Marie Hart
- Alexandra Danielle Harvey
- Megan Hataway
- Curtis James Hawkins II
- Olivia Nicole Hayes
- Rachel Oakley Heist
All providers in Fort Cavazos, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.