Kevin John Shanaghan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A18062 Issued in CA

Practice address

1341 S Eliseo Dr Ste 200
Greenbrae, CA 94904-2000

Phone

(415) 464-8169

Fax

(415) 925-9712

NPI assigned

Jun 28, 2006

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 18

Medicare fee-for-service enrollment

Enrolled in ME, CA2 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

Specialty

Family Practice

Education

University of New England, College of Osteo Medicine, 1988

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
• Novato Community Hospital Hospital, Novato, CA, CCN 050131

Merit-based Incentive Payment System (MIPS)

Final score

81.03 of 100Reported as subgroup

Quality

80.86

Promoting interoperability

76

Improvement activities

40

Cost

75.91

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshanaghan125415@direct-ucsfmedicalcenter.org

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.

• Regents Univ of California UCSF

  dba UCSF Physician Group

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD
• University of California San Francisco

  dba UCSF Medical Center Adult Chronic Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
  • NPI 1992818256
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• The Gettysburg Hospital

  • General Acute Care Hospital
  • Gettysburg, PA
  • NPI 1265466957
  NPD (past)
• York Hospital

  dba WellSpan York Hospital

  • Psychiatric Hospital Unit
  • York, PA
  • NPI 1578587986
  NPD (past)

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

• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Novato, CA
  • NPI 1104059153
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1750318283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 S ELISEO DR STE 200",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042000",
            "telephone_number": "415-464-8169",
            "fax_number": "415-925-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 S ELISEO DR STE 200",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042000",
            "telephone_number": "415-464-8169",
            "fax_number": "415-925-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAGHAN",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007370E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2758",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A18062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001264101",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 PA",
            "identifier": "0527142000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "P004726",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG HERR'S RIDGE",
            "identifier": "140375",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG THURMONT",
            "identifier": "146180",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AH MERCY-WMG THURMONT",
            "identifier": "20026342",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC-WMG THURMONT",
            "identifier": "50021844",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "692270",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "7429",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "219458",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403896",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC-WMG-ST.CHARLES",
            "identifier": "50080314",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5122170",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080187668",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "616924",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "104877",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC-WMG HERR'S RID",
            "identifier": "50018543",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AH MERCY-WMG HERR'S RIDGE",
            "identifier": "20020665",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Michelle Sciacca, PHD
• Pradeepa Selvakumar, MD
• Sequoia Living Inc (The Tamalpais)
• Patricia Ann Serpa
• Sarah Sevi, RN, NP
• Michael Samuel Shapiro, MD
• Ripple Sharma, M.D.
• Karin L. Shavelson, MD
• Kieawnie Dorine Shedrick
• Susan Scherezade Sherman, RD

• Family Medicine Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.