Tyler Jay Shaw, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5304 Road 68
Pasco, WA 99301-8078

Phone

(509) 543-9300

NPI assigned

Jul 7, 2016

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

Medicare fee-for-service enrollment

Enrolled in WA, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Lourdes Hospital LLC

  • Internal Medicine Physician
  • Pasco, WA
  • NPI 1659861060
  Medicare reassignment NPD
• Columbia County Hospital District

  • Critical Access Hospital
  • Dayton, WA
  • NPI 1134128911
  Medicare reassignment
• Health First Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Richland, WA
  • NPI 1821633223
  Medicare reassignment
• Northwest Emergency Physicians LLC

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  Medicare reassignment
• Northwest Physician Associates PC

  • Physician Assistant
  • Arlington, WA
  • NPI 1275567919
  Medicare reassignment
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment
• Columbia County Hospital District

  • Rural Health Clinic/Center
  • Dayton, WA
  • NPI 1518044551
  NPD
• Columbia County Hospital District

  • Primary Care Clinic/Center
  • College Place, WA
  • NPI 1851050264
  NPD
• Health First Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Pasco, WA
  • NPI 1982340170
  NPD

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1548612153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6703 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362623",
            "telephone_number": "509-460-5588",
            "fax_number": "509-736-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 ROAD 68",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018078",
            "telephone_number": "509-543-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523513",
            "country_code": "US",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TYLER",
        "middle_name": "JAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyndra Nicole Scott, LCSW
• Miranda Seal
• Faye Leone Serene, MDIV, LMHCA
• Olivia Serrano, RN
• Richard W Shallman, MD
• Traci Sheets, RN
• Nancy A Shelton, DDS
• Maressa Michele Shepard
• Diane Lois Shepherd, CDP
• Debra Lee Shines, LPN

• Physician Assistant in Pasco, WA
• Providers in Pasco, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.