Andrew Tim Shen, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD-46291 Issued in IA

Practice address

3421 W 9TH St
Waterloo, IA 50702-5401

Phone

(319) 272-5000

Fax

(319) 272-5264

NPI assigned

Jun 27, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Anesthesiology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashen55178@direct.metrohealth.org
• Direct secure messaging: ashen4030479@direct.trinity-health.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.

• Mercy Medical Center

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1700834165
  Medicare reassignment Care Compare group NPD
• Covenant Medical Center Inc

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1548288160
  Medicare reassignment NPD
• Covenant Medical Center, Inc.

  • Customized Equipment (DME)
  • Evansdale, IA
  • NPI 1851141980
  NPD
• Mercy Medical Center

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1114923513
  NPD
• Mercy Medical Center

  • Cardiovascular Disease Physician
  • Cedar Rapids, IA
  • NPI 1669617106
  NPD
• The Metrohealth System

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD

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

• Mercy Medical Center

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1720029333
  Care Compare affiliation

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1538423231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-5264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "215-762-2624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "ANDREW",
        "middle_name": "TIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0081900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT-201576",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "MD-46291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaulis Ia Skilled Nursing Facility, LLC
• Shaulis Ia Skilled Nursing Facility, LLC
• Jennifer Lea Shaw, LISW
• Tera Sheetz
• Sage Shemak
• Julie Anna Shepard, LPN
• Paul David Shepard, PA-C
• Leanne Sherburne, PHARM D, R. PH.
• John Sherret, D.O.
• Warda Shoaib, MD

• Anesthesiology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Anesthesiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.