Active NPI
Olivia Madeline Shaw, MS, PA-C
- Physician Assistant
- Troy, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601011257
- Practice address
- 44201 Dequindre Rd
Troy, MI 48085-1117 - Phone
- (248) 964-8193
- NPI assigned
- Oct 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601011257 | Primary | |
| Medical Physician Assistant | 363AM0700X | 5601011257 | MI |
Addresses
Primary practice location
44201 Dequindre Rd
Troy, MI 48085-1117
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863
Other practice location 1
60005 Campground Rd Ste 600
Washington, MI 48094-3447
Phone (586) 372-3500
Other practice location 2
44199 Dequindre Rd Ste 315
Troy, MI 48085-1128
Phone (248) 964-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535
Hospital & facility affiliations
- Beaumont Hospital, Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Detroit Mercy | Past | Accepting new patients |
Interoperability endpoints
- oshaw825824@direct.hfhs.org
- oshaw1793678@epic00.shdirect.org
Organizations & group practices 3
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Internal Medicine Physician
- Washington, MI
- NPI 1336348002
-
- General Practice Physician
- Detroit, MI
- NPI 1669187696
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1720740665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44201 DEQUINDRE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-8193"
}
],
"practiceLocations": [
{
"address_1": "60005 Campground Rd Ste 600",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "MI",
"postal_code": "480943447",
"country_code": "US",
"telephone_number": "586-372-3500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "44199 Dequindre Rd Ste 315",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851128",
"country_code": "US",
"telephone_number": "248-964-3600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAW",
"first_name": "OLIVIA",
"middle_name": "MADELINE",
"credential": "MS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-07",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "5601011257",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601011257",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.