Individual provider Active NPI

Regina Ann Shaw, M.D.

  • Anesthesiology Physician
  • Sacramento, CA
National Provider Identifier
1710971403
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G84921 Issued in CA
Practice address
3315 Watt Ave
Sacramento, CA 95821-3600
Phone
(916) 481-6800
Fax
(916) 481-1881
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G84921 CA Primary

Addresses

Primary practice location

3315 Watt Ave
Sacramento, CA 95821-3600

Mailing address

PO Box 660910
Sacramento, CA 95866-0910
Phone (916) 481-6800

Other identifiers 1

IdentifierTypeStateIssuer
GR0028370MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 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
I20031209001117 CA Practitioner - Anesthesiology 5496651564 Reassigns benefits to 1 organization
I20190228002860 WA Practitioner - Anesthesiology 5496651564 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G84921CAMDAnesthesiology Physician
212438NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Anesthesia Service Exchange Medical Group, Inc. Anesthesiology CurrentSince Nov 1, 2003 Accepting new patients
Bellingham Anesthesia Associates, P.S. Anesthesiology CurrentSince Dec 11, 2018 Accepting new patients
Providence Wa Anesthesia Services, P.C. Anesthesiology Past Accepting new patients
Warren Anesthesiologists Prof Corp Anesthesiology PastSince Mar 15, 2010 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology Past Accepting new patients

Locations

3315 Watt Ave
Sacramento, CA 95821
Phone (916) 481-0777

909 Squalicum Way
Ste 102
Bellingham, WA 98225
Phone (360) 647-3377

2980 Squalicum Pkwy
Ste 304
Bellingham, WA 98225
Phone (360) 647-3377

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1710971403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660910",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958660910",
            "telephone_number": "916-481-6800",
            "fax_number": "916-481-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213600",
            "telephone_number": "916-481-6800",
            "fax_number": "916-481-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "REGINA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G84921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0028370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.