Individual provider Active NPI

Stephen Damien Shields, M.D.

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1548480858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PENDING Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(973) 926-7000
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PENDING NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

187 Warren St
#203
Jersey City, NJ 07302-6475
Phone (718) 938-5245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100609000625 TX Practitioner - Emergency Medicine 1254418254 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGNJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Aug 28, 2024 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Dec 6, 2024 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Apr 1, 2010 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients

Locations

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

8200 Highway 6
Sienna Plantation, TX 77459
Phone (713) 441-3724

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: sshields27870@directhoustonmethodist.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548480858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WARREN ST",
            "address_2": "#203",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026475",
            "telephone_number": "718-938-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "STEPHEN",
        "middle_name": "DAMIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.