Colette Shaw, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD442733 Issued in PA

Practice address

111 S 11TH St
Ste 3390
Philadelphia, PA 19107-4824

Phone

(215) 955-6226

Fax

(215) 923-1562

NPI assigned

Jun 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, GA2 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

Diagnostic Radiology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Atlanta PAGroup PAC ID 4486647435, 41 clinicians

Piedmont Community Imaging LLCGroup PAC ID 6406346527, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
• Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
• Shepherd Center Long-term care hospital, Atlanta, GA, CCN 112003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Piedmont Community Imaging, LLC

  • Radiology Clinic/Center
  • Columbus, GA
  • NPI 1134011331
  Medicare reassignment Care Compare group NPD
• Radiology Associates of Atlanta, PA

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1528043718
  Medicare reassignment Care Compare group NPD

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

• Eastside Medical Center, LLC

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Fayette Community Hospital, Inc.

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation
• Piedmont Newnan Hospital, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1134133002
  Care Compare affiliation
• Shepherd Center Inc

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1043311715

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1780810986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "STE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "STE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COLETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD442733",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD442733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102615625",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266841",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaw Mindful Medicine PLLC
• Allan S. Shaw, DDS
• Brittany Shaw
• Caitlin Shaw, DPT
• Carli Shaw, OTR/L
• Colleen Shaw
• Colleen Marie Shaw
• Geraldine M. Shaw, OT
• Jill Shaw, MS, LPC
• Katharina Stephanie Shaw, MD

• Vascular & Interventional Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Vascular & Interventional Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.