NPIMap

Individual provider Active NPI

Charles W Shafer, M.D.

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1720052228
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1917 Issued in SD
Practice address
1115 E 20TH St
Sioux Falls, SD 57105-1013
Phone
(605) 575-1616
Fax
(605) 367-7157
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1917 SD Primary

Addresses

Primary practice location

1115 E 20TH St
Sioux Falls, SD 57105-1013

Mailing address

1115 E 20TH St
Sioux Falls, SD 57105-1013
Phone (605) 575-1616

Other practice location 1

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-6428

Other identifiers 2

IdentifierTypeStateIssuer
5605100MedicaidSD
951814200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20050510000223 SD Practitioner - Family Practice 8224078225 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family MedicineGroup PAC ID 2769478429, 16 clinicians
City of Sioux FallsGroup PAC ID 7810943859, 21 clinicians

Practice addresses (Care Compare)

1115 E 20TH St
Sioux Falls, SD 57105-1013
Phone (605) 339-1783

521 N Main Ave
Suite 100
Sioux Falls, SD 57104-5947
Phone (605) 367-8793

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.9 of 100Reported as group
Quality
96.46
Promoting interoperability
99
Improvement activities
40
Cost
75.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Sep 18, 2024 Accepting new patients
Avera St Marys Current Accepting new patients
Avera St. Mary'S CurrentSince Sep 18, 2024 Accepting new patients
City of Sioux Falls CurrentSince Aug 7, 1989 Accepting new patients
Center for Family Medicine Family Medicine CurrentSince Jan 1, 1973 Accepting new patients
City of Sioux Falls Current Accepting new patients
Avera McKennan Past Accepting new patients
Sanford Medical Center Past Accepting new patients

Locations

521 N Main Ave
Ste 100
Sioux Falls, SD 57104
Phone (605) 367-8029

1115 E 20th St
Sioux Falls, SD 57105
Phone (605) 339-1783

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Interoperability endpoints

  • Direct secure messaging: charles.shafer@centerforfamilymedicine.eclinicaldirectplus.com

Organizations & group practices 8

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 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1720052228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E 20TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051013",
            "telephone_number": "605-575-1616",
            "fax_number": "605-367-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E 20TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051013",
            "telephone_number": "605-575-1616",
            "fax_number": "605-367-7157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 S Cliff Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051007",
            "country_code": "US",
            "telephone_number": "605-322-6428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5605100",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951814200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.