Individual provider Active NPI

Timothy E Shiben, M.D.

  • Gastroenterology Physician
  • Paducah, KY
National Provider Identifier
1780652347
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
33237 Issued in KY
Practice address
2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3800
Phone
(270) 415-4690
Fax
(270) 415-4691
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036-102314 IL
Gastroenterology Physician 207RG0100X 33237 KY Primary

Addresses

Primary practice location

2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3800

Mailing address

2605 Kentucky Ave
Suite 306
Paducah, KY 42003-3800
Phone (270) 415-4690

Other identifiers 1

IdentifierTypeStateIssuer
64332372MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tshiben8756@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20050223000081 KY Practitioner - Gastroenterology 0840243580 Reassigns benefits to 1 organization
I20111109000616 IL Practitioner - Gastroenterology 0840243580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
West Virginia University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3801
Phone (270) 441-4700

28 Chick St
Metropolis, IL 62960-2467
Phone (270) 415-4690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy164
Upper gastrointestinal (GI) endoscopy for acid reflux208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-102314ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Sep 28, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 28, 2015 Accepting new patients

Locations

28 Chick St
Metropolis, IL 62960
Phone (618) 427-2680

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

225 Medical Center Dr
Ste 307
Paducah, KY 42003
Phone (270) 441-4700

2605 Kentucky Ave
Ste 306
Paducah, KY 42003
Phone (270) 415-7653

2605 Kentucky Ave
Ste 202
Paducah, KY 42003
Phone (270) 415-4690

Organizations & group practices 2

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 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1780652347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-4690",
            "fax_number": "270-415-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 202",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-4690",
            "fax_number": "270-415-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBEN",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-102314",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "33237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64332372",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tshiben8756@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2605 Kentucky Ave",
            "address_2": "Suite 202",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.