Peter Joseph Shaw, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01087769A Issued in IN

Practice address

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160

Phone

(260) 435-7001

NPI assigned

Apr 1, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Emergency Medicine

Education

Wayne State University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048
• St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pshaw475839@reidhealth.direct-ci.com

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.

• Reid Physician Associates, Inc.

  dba Reid Health Physician Associates

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment Care Compare group NPD
• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment NPD
• Reid Physician Associates, Inc

  dba Reid Health X-Ray Winchester

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD

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

• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Reid Hospital & Health Care Services, Inc

  dba Reid Health

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation
• St. Joseph Health System, LLC

  dba Lutheran Downtown Hospital

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1023060472
  Care Compare affiliation

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1568924454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044160",
            "telephone_number": "260-435-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044160",
            "telephone_number": "260-435-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01087769A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4351044601",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pshaw475839@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shashi K Ahuja M.D.
• Elizabeth Shaw
• Erin L. Shaw, NP
• Melissa Shaw, FNP
• Nicole B Shaw, NP
• Serenity Shaw, RBT
• Tiffany Shaw, BCBA
• Todd Shaw
• SHCS, Inc (Sunshine Home Care Services)
• Thomas Allen Shealy, MD

• Emergency Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.