Individual provider Active NPI

Kathryn Weber Shaw, MD

  • Surgery Physician
  • Hollywood, FL
National Provider Identifier
1649515297
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME141862 Issued in FL
Practice address
1150 N 35TH Ave Ste 390
Hollywood, FL 33021-5429
Phone
(954) 265-7450
Fax
(954) 265-7459
NPI assigned
Dec 9, 2012
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60740019 WA
Surgery Physician 208600000X ME141862 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 390
Hollywood, FL 33021-5429

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kshaw218014@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20220921001941 MO Practitioner - General SurgeryPractitioner - Other (Physician) 5799054409 Reassigns benefits to 1 organization
I20220921002082 KS Practitioner - General SurgeryPractitioner - Other (Physician) 5799054409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4321 Washington St
Suite 4000
Kansas City, MO 64111-5965
Phone (816) 932-3300

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60740019WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Sep 3, 2019 Accepting new patients
South Broward Hospital District CurrentSince Sep 3, 2019 Accepting new patients
Saint Luke's Physician Group Inc Surgery CurrentSince Aug 15, 2022 Accepting new patients
St Lukes Hospital of Kansas City Past Accepting new patients

Locations

1150 N 35th Ave
Ste 390
Hollywood, FL 33021
Phone (954) 265-7450

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

1035 N Emporia Ave
Ste 185
Wichita, KS 67214
Phone (316) 303-1045

4320 Wornall Rd
Ste 240
Kansas City, MO 64111
Phone (816) 932-3550

4320 Wornall Rd
Ste 304
Kansas City, MO 64111
Phone (816) 932-3550

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4
  • Direct secure messaging: kshaw218014@mhsdirect.net
  • Direct secure messaging: kshaw451858@direct.saint-lukes.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1649515297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 390",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215429",
            "telephone_number": "954-265-7450",
            "fax_number": "954-265-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KATHRYN",
        "middle_name": "WEBER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-09",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60740019",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME141862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshaw218014@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave Ste 390",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.