Individual provider Active NPI

Scott David Shie, M.D.

  • Urology Physician
  • Angola, IN
National Provider Identifier
1619167236
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01069915A Issued in IN
Practice address
306 E Maumee St Ste 303
Angola, IN 46703-2044
Phone
(606) 675-1482
Fax
(260) 667-5689
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01069915A IN Primary

Addresses

Primary practice location

306 E Maumee St Ste 303
Angola, IN 46703-2044

Mailing address

416 E Maumee St
Angola, IN 46703-2015

Other identifiers 2

IdentifierTypeStateIssuer
3160252MedicaidOH
201021740MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshie1039158@direct.ohiohealth.com OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110721000672 IN Practitioner - Urology 9739357526 Reassigns benefits to 2 organizations
I20111227000693 OH Practitioner - Urology 9739357526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Cincinnati College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

306 E Maumee St
Suite 303
Angola, IN 46703-2044
Phone (260) 667-5685

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069915AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital, Inc Urology CurrentSince Apr 14, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
Van Wert Medical Services, LTD. CurrentSince May 1, 2020 Accepting new patients
Van Wert Medical Services, LTD. CurrentSince May 1, 2020 Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Apr 14, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
Cameron Memorial Community Hospital Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

306 E Maumee St
Ste 303
Angola, IN 46703
Phone (260) 665-8494

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

140 Fox Rd
Ste 105
Van Wert, OH 45891
Phone (419) 228-7275

Organizations & group practices 8

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 5

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1619167236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST STE 303",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032044",
            "telephone_number": "606-675-1482",
            "fax_number": "260-667-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIE",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01069915A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3160252",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201021740",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshie1039158@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "140 Fox Rd Ste 105",
            "city": "Van Wert",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458912490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.