NPIMap

Individual provider Active NPI

Paul M Shen, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Green Bay, WI
National Provider Identifier
1831382423
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
57710-20 Issued in WI
Practice address
835 S Van Buren St
Green Bay, WI 54301-3526
Phone
(920) 496-4700
NPI assigned
Aug 27, 2007
Last updated
Sep 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35089291 OH
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 57710-20 WI Primary

Addresses

Primary practice location

835 S Van Buren St
Green Bay, WI 54301-3526

Mailing address

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
2752936MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20121106000585 WI Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 7012001407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)12
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57710-20WIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 8, 2014 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Sep 8, 2014 Accepting new patients

Locations

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1831382423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35089291",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "57710-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2752936",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.