NPIMap

Individual provider Active NPI

Paul Eugene Shields, DO

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1508861949
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS010676L Issued in PA
Practice address
2501 W 12TH St
Suite 1
Erie, PA 16505-4527
Phone
(814) 806-1144
Fax
(814) 833-0659
NPI assigned
Jun 14, 2005
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS010676L PA Primary

Addresses

Primary practice location

2501 W 12TH St
Suite 1
Erie, PA 16505-4527

Mailing address

397 Churchill Hubbard Rd
Youngstown, OH 44505-1375
Phone (330) 759-6750

Other practice location 1

705 Maple Rd
Williamsville, NY 14221-3291
Phone (716) 631-8400

Other identifiers 3

IdentifierTypeStateIssuer
03446839MedicaidNY
001370726OtherPAHIGHMARK BCBS
0018397920004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141126000390 NY Practitioner - Family Practice 9335193515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS010676LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Shields Medicine PLLC Family Medicine CurrentSince Feb 15, 2026 Accepting new patients
2850 Grand Island Boulevard Operating Company LLC Past Accepting new patients
1818 Como Park Boulevard Operating Company LLC Past Accepting new patients
225 Bennett Road Operating Company LLC Past Accepting new patients
Kaleida Health Past Accepting new patients
2600 Niagara Falls Boulevard Operating Company LLC Past Accepting new patients
Erie Physicians Network PC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice Buffalo, Inc.Cheektowaga, NY, CCN 331502 Hospice Corporate Director Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1508861949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 CHURCHILL HUBBARD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051375",
            "telephone_number": "330-759-6750",
            "fax_number": "330-759-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W 12TH ST",
            "address_2": "SUITE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054527",
            "telephone_number": "814-806-1144",
            "fax_number": "814-833-0659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142213291",
            "country_code": "US",
            "telephone_number": "716-631-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "PAUL",
        "middle_name": "EUGENE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010676L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03446839",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "001370726",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018397920004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.