Individual provider Active NPI

Shawn C. Nessen, DO

  • Surgical Critical Care Physician
  • Live Oak, TX
National Provider Identifier
1790742997
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
S7106 Issued in TX
Practice address
12709 Toepperwein Rd Ste 302
Live Oak, TX 78233-3260
Phone
(210) 653-9307
Fax
(210) 653-7014
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X S7106 TX
Trauma Surgery Physician 2086S0127X S7106 TX
Surgical Critical Care Physician 2086S0102X S7106 TX Primary

Addresses

Primary practice location

12709 Toepperwein Rd Ste 302
Live Oak, TX 78233-3260

Mailing address

1701 W Charleston Blvd
#215
Las Vegas, NV 89102-2325
Phone (702) 671-2395

Other practice location 1

2040 W Charleston Blvd
Suite 302
Las Vegas, NV 89102-2227
Phone (910) 425-9710

Other practice location 2

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-5864

Other identifiers 2

IdentifierTypeStateIssuer
P02587370OtherTXMCRR
417623201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201119000186 TX Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7719176429

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Merit-based Incentive Payment System (MIPS)

Final score
84.46 of 100Reported as group
Quality
71.92
Promoting interoperability
99
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S7106TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC Surgery CurrentSince May 1, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

12500 Judson Rd
Ste 220
Live Oak, TX 78233
Phone (210) 653-9307

12709 Toepperwein Rd
Ste 302
Live Oak, TX 78233
Phone (210) 653-9307

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

Interoperability endpoints

  • Direct secure messaging: snessen237612@christushealth.direct-ci.net
  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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 3

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1790742997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD",
            "address_2": "#215",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022325",
            "telephone_number": "702-671-2395",
            "fax_number": "702-382-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD STE 302",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333260",
            "telephone_number": "210-653-9307",
            "fax_number": "210-653-7014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 W Charleston Blvd",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022227",
            "country_code": "US",
            "telephone_number": "910-425-9710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-5864",
            "fax_number": "903-606-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESSEN",
        "first_name": "SHAWN",
        "middle_name": "C.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S7106",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "S7106",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "S7106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02587370",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417623201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.