Michael Jonathan Shaw, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

137054-2 Issued in NY

Practice address

4900 Broad Rd
Syracuse, NY 13215-2265

Phone

(315) 492-5535

Fax

(315) 492-5222

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawmi@hiemail.healtheconnections.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.

• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162
  Medicare reassignment NPD
• Onondaga Hill E R Physicians, LLP

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1699708479
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1497775787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5535",
            "fax_number": "315-492-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5535",
            "fax_number": "315-492-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MICHAEL",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "137054-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01352496",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Gorgon Shaw, M.D.
• James Albert Shaw, M.D.
• Maizie Marie Shaw
• Mary Shaw, RN
• Melinda M Shaw, PA
• Palma M Shaw, M.D.
• Susan F. Shaw, NP
• Ajaz B Shawl, MD, FACP
• Hatham Shawqi, D.O.
• Patricia Anne Shay, NP

• Emergency Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.