Individual provider Active NPI

Michelle Shafer, D.O.

  • Family Medicine Physician
  • Dubuque, IA
National Provider Identifier
1770923666
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-04748 Issued in IA
Practice address
1000 Langworthy St
Dubuque, IA 52001-7365
Phone
(563) 584-3455
Fax
(563) 584-3451
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-04748 IA Primary

Addresses

Primary practice location

1000 Langworthy St
Dubuque, IA 52001-7365

Mailing address

1000 Langworthy St
Dubuque, IA 52001-7365
Phone (563) 584-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20150803000243 IA Practitioner - Family Practice 6406160647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100

Hospital & facility affiliations

  • Mercyone Dubuque Medical Center Hospital, Dubuque, IA, CCN 160069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-04748IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Clinic P C CurrentSince Jul 1, 2024 Accepting new patients

Locations

1515 Delhi St
Ste 100
Dubuque, IA 52001
Phone (319) 557-9111

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1770923666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017365",
            "telephone_number": "563-584-3455",
            "fax_number": "563-584-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017365",
            "telephone_number": "563-584-3455",
            "fax_number": "563-584-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-04748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.