Susan L Gin-Shaw, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

17053 Issued in AZ

Practice address

19829 N 27TH Ave
Phoenix, AZ 85027-4001

Phone

(623) 879-5445

NPI assigned

Dec 9, 2005

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

Other identifiers 3

Other names 1

• Dr. Susan L Gin Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment NPD
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Ingenuity Medical Group LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1417986118
  NPD (past)
• Valley Hyperbarics LLC

  • Personal Emergency Response Attendant
  • Chandler, AZ
  • NPI 1760439244
  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1659356806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 N 9TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850071708",
            "telephone_number": "602-689-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19829 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274001",
            "telephone_number": "623-879-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIN-SHAW",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "17053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00266840",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293358",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "86080015085259A283",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GIN",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Killian Marie Gilreath
• Robert William Gilson, PTA, MT
• Joanna Grisel Gim
• Samantha Gimbel, PHARM D
• Rebecca Lynn Gimbrone, BSED
• Brandon Gin
• Lucia Gines, RN, IBCLC
• Ginger Price DDS
• Jessica Ginn
• Taylor Ginsberg, DMD

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.