NPIMap

Individual provider Active NPI

Charles David O'Shaughnessy, M.D.

  • Interventional Cardiology Physician
  • Elyria, OH
National Provider Identifier
1831178003
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35040861 Issued in OH
Practice address
125 E Broad St
Suite 305
Elyria, OH 44035-6400
Phone
(440) 414-9100
Fax
(216) 201-5578
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35040861 OH
Interventional Cardiology Physician 207RI0011X 35040861 OH Primary

Addresses

Primary practice location

125 E Broad St
Suite 305
Elyria, OH 44035-6400

Mailing address

125 E Broad St
Suite 305
Elyria, OH 44035-6400
Phone (440) 414-9100

Other identifiers 6

IdentifierTypeStateIssuer
341221800067OtherOHCARESOURCE
060013316OtherRAILROAD MEDICARE
E40861OtherOHSUMMACARE
0454244MedicaidOH
100408OtherOHKAISER
000000128711OtherOHANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlesoshaughnessy@nohomg.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208000961 OH Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0749187623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Toledo College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

125 E Broad St
Suite 218
Elyria, OH 44035-6447
Phone (440) 329-7310

158 W Main Rd
Conneaut, OH 44030-2039

29325 Health Campus Dr
Westlake, OH 44145-8201

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • Fisher-Titus Hospital Hospital, Norwalk, OH, CCN 360065
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting38
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35040861OHMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Cardiovascular Disease CurrentSince Oct 1, 2021 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2021 Accepting new patients
Elyria Cardiac Cath Lab, LLC PastSince Feb 24, 2006 Accepting new patients
University Primary Care Practices Past Accepting new patients
North Ohio Heart Center Inc Cardiovascular Disease Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29325 Health Campus Dr
Ste 3
Westlake, OH 44145
Phone (440) 414-9400

Interoperability endpoints

  • Direct secure messaging: coshaughnessy37287@ehrdirect.uhhospitals.org

Organizations & group practices 6

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 7

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1831178003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE 305",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-414-9100",
            "fax_number": "216-201-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE 305",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-414-9100",
            "fax_number": "216-201-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHAUGHNESSY",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35040861",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35040861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341221800067",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060013316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "E40861",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0454244",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "100408",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000128711",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesoshaughnessy@nohomg.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "125 E Broad St",
            "address_2": "Suite 305",
            "city": "Elyria",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440356400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.