Individual provider Active NPI

Shane Anton Creado, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Madison, WI
National Provider Identifier
1578829230
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
61303-20 Issued in WI
Practice address
2727 Marshall CT
Madison, WI 53705-2255
Phone
(608) 238-9354
Fax
(608) 238-7675
NPI assigned
Apr 7, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 61303-20 WI Primary

Addresses

Primary practice location

2727 Marshall CT
Madison, WI 53705-2255

Mailing address

2727 Marshall CT
Madison, WI 53705-2255
Phone (608) 238-9354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Nov 7, 2017 through Nov 7, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61303-20WIMDSleep Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578829230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 MARSHALL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052255",
            "telephone_number": "608-238-9354",
            "fax_number": "608-238-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 MARSHALL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052255",
            "telephone_number": "608-238-9354",
            "fax_number": "608-238-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREADO",
        "first_name": "SHANE",
        "middle_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WI",
            "license": "61303-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.