Marianne L Shaw, M.D.
Individual provider Active NPI Rheumatology Physician · Tyrone, PA
NPI 1790785582 · NPPES record last updated Aug 2, 2024
Key facts
- NPI
- 1790785582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rheumatology Physician 207RR0500X
- License
- MD4238723 (PA)
- Practice address
- 154 Hospital Dr
Tyrone, PA 16686 - Phone
- (814) 684-6341
- Fax
- (814) 684-6343
- NPI assigned
- Jul 22, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 46
Medicare Care Compare profile
- Specialty
- Rheumatology
- Education
- Temple University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- J C Blair Memorial Hospital
Practice addresses (Care Compare)
1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-2290
417 Sabbath Rest Rd
Altoona, PA 16601-7567
Hospital & facility affiliations
- Penn Highlands Huntingdon
- Penn Highlands Dubois
- Upmc Altoona
- Penn Highlands Tyrone
- Conemaugh Memorial Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040901000762 | PA | Practitioner - Rheumatology | 9931174976 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD4238723 | PA | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| J C Blair Memorial Hospital | Current |
Accepting new patients | |
| J C Blair Memorial Hospital | Current |
Accepting new patients | |
| J C Blair Memorial Hospital | Current | Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Rheumatology | Current |
Accepting new patients |
| Conemaugh Health Initiatives | Past |
Accepting new patients | |
| Altoona Speciality Center LLC | Past | Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients | |
| J. C. Blair Memorial Hospital | Past | Accepting new patients |
Locations
417 Sabbath Rest Rd
Ste 4
Altoona, PA 16601
Phone (814) 375-6467
100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040
621 S Main St
Dubois, PA 15801
Phone (814) 299-7520
1792 Plank Rd
Duncansville, PA 16635
Phone (814) 317-5188
1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740
154 Hospital Dr
Ste 3
Tyrone, PA 16686
Phone (814) 684-6347
Interoperability endpoints
- mshaw@tyronespecialties.medentdirect.com
- mlshaw2@1285.direct.myezyaccess.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | MD4238723 | PA | Yes |
Addresses
Primary practice location
154 Hospital Dr
Tyrone, PA 16686
Mailing address
154 Hospital Dr
Tyrone, PA 16686
Phone (814) 684-6341
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007706880003 | Medicaid | PA | |
| 338517 | Other | PA | BLUE SHIELD |
Other providers in Tyrone, PA
- Victor H Santillan
- John A Schroth
- Shane Sergent
- Kaitlin Shanafelt
- Jaelyn Shaw
- Jacob Richard Shelow
- Timothy Stephen Skarada
- Robert James Sloss
- Angela Sloter
- Crystal Lynn Smith
All providers in Tyrone, PA · Rheumatology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.