Shanda Rae Dorff, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52481 Issued in MN

Practice address

4700 Lexington Ave N Ste C
Shoreview, MN 55126-5964

Phone

(651) 756-9595

Fax

(651) 340-8529

NPI assigned

Apr 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Shanda Rae Lawson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Specialty

Family Practice

Education

University of Missouri, Kansas City, School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stevens Community Medical Center IncGroup PAC ID 3678475852, shared by 6 NPIs, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1760657498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270653",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551270653",
            "telephone_number": "651-756-9595",
            "fax_number": "651-340-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LEXINGTON AVE N STE C",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551265964",
            "telephone_number": "651-756-9595",
            "fax_number": "651-340-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFF",
        "first_name": "SHANDA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "52481",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "70139-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDA",
            "last_name": "LAWSON",
            "middle_name": "RAE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Liban Dima
• Larissa M Dimitrov, MD
• Kimberly A Donahue, PT, DPT
• Tacy Donnelly
• Sarah Newberry Donovan, LPCC, MT-BC
• Dr Joshua C Jones PLLC
• Terence L. Drassal, D.C.
• Charles K Dunham, MD
• David Robert Dunphy, DDS
• Ecumen

• Family Medicine Physician in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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; Opt Out Affidavits.
• 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.