Kathleen A Shore, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A12544 Issued in CA

Practice address

2400 Tucker NE
Albuquerque, NM 87131-0001

Phone

(505) 272-1734

Fax

(505) 272-6308

NPI assigned

Jun 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ventura County Medical Center Hospital, Ventura, CA, CCN 050159

Merit-based Incentive Payment System (MIPS)

Final score

86.02 of 100Reported as group

Quality

64.51

Promoting interoperability

100

Improvement activities

40

Cost

72.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• County of Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment Care Compare group NPD
• County of Ventura

  • Federally Qualified Health Center (FQHC)
  • Thousand Oaks, CA
  • NPI 1316188253
  NPD
• County of Ventura

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD

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

• County of Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Care Compare affiliation

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1720240492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064375",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 TUCKER NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-1734",
            "fax_number": "505-272-6308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2240 E Gonzales Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930368212",
            "country_code": "US",
            "telephone_number": "805-981-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A156710",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R1020",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathleen.shore@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "2240 E Gonzales Rd Ste 100",
            "city": "Oxnard",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930368212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cameron Claibourne Shonnard, MD
• Heather Shoop
• Michael Shoop, MD
• Daniel Nathan Shorb, LMHC
• Gretchen Shore, OT
• Shoreline Highway
• Darrah Jackson Short, LMSW
• Maryhelen Short, LCSW
• Tonya Michelle Short
• Mark C Shortencarier, R.PH.

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.