Corey A Shaw, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

302098 Issued in NY

Practice address

PSC 819 Box 4377
Fpo, AE 09645-0044

Phone

34956823431

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, NY, CA, AZ4 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 4

Specialty

Diagnostic Radiology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Imaging LLCGroup PAC ID 2466496880, 126 clinicians

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

Howard John Simon MD PCGroup PAC ID 1658602263, 36 clinicians

Health Diagnostics of California a Professional CorporationGroup PAC ID 4284621525, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Elite Imaging, LLC

  dba Akumin

  • Diagnostic Radiology Physician
  • Aventura, FL
  • NPI 1942208319

  CA

  Medicare reassignment Care Compare group NPD
• Health Diagnostics of California a Professional Corporation

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Mountain View, CA
  • NPI 1104321959

  AZ

  Medicare reassignment Care Compare group NPD
• Howard John Simon MD PC

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1932768934

  AZ

  Medicare reassignment Care Compare group NPD
• Simonmed Imaging Florida LLC

  dba Simonmed Imaging Tampa

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  AZ

  Medicare reassignment Care Compare group NPD
• Smi Imaging, LLC

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489
  Medicare reassignment Care Compare group NPD
• St Agnes Healthcare Inc

  dba Integrated Specialists Group

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176
  Medicare reassignment NPD
• Zwanger & Pesiri Radiology Group, LLP

  • Diagnostic Radiology Physician
  • Lindenhurst, NY
  • NPI 1477523413
  Medicare reassignment NPD
• Afo Imaging Inc

  dba Advanced Diagnostic Group

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1740366764
  NPD
• American Health Imaging of Florida LLC

  dba Premier Advanced Imaging of Lake Mary LLC

  • Radiology Clinic/Center
  • Lake Mary, FL
  • NPI 1689650210
  NPD
• American Health Imaging of Georgia LLC

  dba American Health Imaging of Brunswick, LLC

  • Radiology Clinic/Center
  • Brunswick, GA
  • NPI 1548785330
  NPD
• American Health Imaging of Georgia LLC

  dba American Health Imaging of Augusta LLC

  • Radiology Clinic/Center
  • Augusta, GA
  • NPI 1790113082
  NPD
• Bowes Imaging Center LLC.

  • Diagnostic Radiology Physician
  • Bradenton, FL
  • NPI 1316985658
  NPD

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1720066830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SUNRISE HWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572539",
            "telephone_number": "34643046423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "PSC 819 BOX 4377",
            "city": "FPO",
            "state": "AE",
            "postal_code": "096450044",
            "telephone_number": "34956823431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "302098",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0102203234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.