Individual provider Active NPI

Siarra Shaw, PA-C

  • Surgical Physician Assistant
  • Livingston, NJ
National Provider Identifier
1649932534
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
200 S Orange Ave Ste 295
Livingston, NJ 07039-5817
Phone
(201) 449-1000
NPI assigned
Oct 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X NY
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA16054 TX
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X NJ Primary

Addresses

Primary practice location

200 S Orange Ave Ste 295
Livingston, NJ 07039-5817

Mailing address

200 S Orange Ave Ste 295
Livingston, NJ 07039-5817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621003398 TX Practitioner - Physician Assistant 7719420470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1004 W 32ND St
200 Ascension Texas Spine and Scoliosis
Austin, TX 78705-1006
Phone (512) 324-3580

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000

1400 N Ih 35
Austin, TX 78701-1926

1400 N Ih 35 LL
Cl400 Tri County Prac Assoc
Austin, TX 78701-1926
Phone (512) 324-7300

6811 Austin Ctr Blvd
Austin, TX 78731-3157

Hospital & facility affiliations

  • Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16054TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors Multi-Specialty CurrentSince May 13, 2024 Accepting new patients
Seton Family of Doctors CurrentSince May 13, 2024 Accepting new patients

Locations

1601 Trinity St
Ste 704D
Austin, TX 78712

1601 Trinity St
Stop 704
Austin, TX 78712
Phone (512) 324-8300

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

6811 Austin Center Blvd
Ste 420
Austin, TX 78731
Phone (512) 324-2715

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Interoperability endpoints

  • Direct secure messaging: siarra.shaw.1@8363.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1649932534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 295",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 295",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "201-449-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SIARRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA16054",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.