Miranda Grace Perleberg Shaw, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0003845 Issued in CO

Practice address

4863 N Nevada Ave Ste 380
Colorado Springs, CO 80918-3951

Phone

(719) 255-8003

Fax

(719) 255-8075

NPI assigned

Jun 24, 2008

Sex

Female

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 CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of Colorado 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Regents of the University of Colorado

  • Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1801226048

  Clinical, CO

  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1790141984

  CO

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  Clinical, CO

  Medicare reassignment NPD
• The Regents of the University of Colorado

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1982425674
  Care Compare group NPD
• Regents of the University of Colorado

  • Clinical Medical Laboratory
  • Aurora, CO
  • NPI 1134369457
  Care Compare group
• Regents of the University of Colorado

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Denver, CO
  • NPI 1235216532
  Care Compare group
• Regents of the University of Colorado

  • Federally Qualified Health Center (FQHC)
  • Aurora, CO
  • NPI 1366180507
  Care Compare group
• Regents of the University of Colorado

  • Specialty Pharmacy
  • Aurora, CO
  • NPI 1588766968
  Care Compare group
• The Regents of the University of Colorado

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1750657722
  Care Compare group
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Psychologist

  NPD

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1629239405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 S BLISSFUL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809171534",
            "telephone_number": "720-891-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4863 N NEVADA AVE STE 380",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183951",
            "telephone_number": "719-255-8003",
            "fax_number": "719-255-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MIRANDA",
        "middle_name": "GRACE PERLEBERG",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0003845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Shaw
• Grace Shaw, O.D.
• Jeffrey Gordon Shaw, M.S.
• Lindsay Shaw, ED.D.
• Marcus Shaw
• Nadine Patience Shaw
• Robert David Shaw, BC-HIS
• Sarah Belen Shaw
• Stacey Shaw, NP
• Tara Shaw

• All providers in Colorado Springs, CO
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.