NPIMap

Individual provider Active NPI

Andrew R Shors, MD

  • Dermatology Physician
  • Kalispell, MT
National Provider Identifier
1669552659
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
49148 Issued in MT
Practice address
60 Four Mile Drive Ste 11
Kalispell, MT 59901-2663
Phone
(406) 314-4788
NPI assigned
Oct 16, 2006
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 49148 MT Primary
MOHS-Micrographic Surgery Physician 207ND0101X 49148 MT

Addresses

Primary practice location

60 Four Mile Drive Ste 11
Kalispell, MT 59901-2663

Mailing address

40 Four Mile Drive
Ste 7
Kalispell, MT 59901-2655
Phone (406) 314-4788

Other practice location 1

UWMC-Roosevelt
4225 Roosevelt Way NE
Seattle, WA 98105-6166
Phone (206) 598-4067

Other identifiers 2

IdentifierTypeStateIssuer
194630OtherINTERNAL ID-MOTOR VEHICLE ID
8387995MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160721001965 MT Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 3678556131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Washington School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highline Dermatology and Skin CancerGroup PAC ID 0749529055, 6 clinicians

Practice addresses (Care Compare)

505 Cascade Loop
Kalispell, MT 59901-7370
Phone (406) 314-4788

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
82.27
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision159
Removal of skin lesions2788
Removal of skin cancer558
Removal or shaving of skin growth31
Skin biopsy520

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49148MTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Dermatology PC Dermatology CurrentSince Sep 6, 2020 Accepting new patients
Highline Dermatology & Skin Cancer Dermatology CurrentSince Aug 1, 2020 Accepting new patients
Mountain West Plastic Surgery and Medical Spa, PLLC CurrentSince Oct 30, 2022 Accepting new patients
University of Washington Past Accepting new patients

Locations

298 Osloski Rd
Eureka, MT 59917
Phone (406) 297-3145

40 Four Mile Dr
Ste 7
Kalispell, MT 59901
Phone (406) 314-4788

505 Cascade Loop
Kalispell, MT 59901
Phone (406) 314-4788

60 Four Mile Dr
Ste 11
Kalispell, MT 59901
Phone (406) 314-4788

103 Whitewater Pl
Ste C
Polson, MT 59860
Phone (406) 314-4788

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 8

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1669552659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FOUR MILE DRIVE",
            "address_2": "STE 7",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012655",
            "telephone_number": "406-314-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FOUR MILE DRIVE STE 11",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012663",
            "telephone_number": "406-314-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UWMC-Roosevelt",
            "address_2": "4225 Roosevelt Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056166",
            "country_code": "US",
            "telephone_number": "206-598-4067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORS",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MT",
            "license": "49148",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MT",
            "license": "49148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "194630",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8387995",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.