Individual provider Active NPI

Gregory Scott Shaw, NP

  • Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1841820834
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95017132 Issued in CA
Practice address
40910 Fremont Blvd
Fremont, CA 94538-4375
Phone
(510) 770-8040
NPI assigned
Jan 19, 2020
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95193337 CA
Nurse Practitioner 363L00000X 95017132 CA Primary

Addresses

Primary practice location

40910 Fremont Blvd
Fremont, CA 94538-4375

Mailing address

40910 Fremont Blvd
Fremont, CA 94538-4375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013002612 CA Practitioner - Nurse Practitioner 1951745462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 National Dr
Suite 135
Sacramento, CA 95834-1947

40910 Fremont Blvd
Fremont, CA 94538-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Health CurrentSince Jul 31, 2025 Accepting new patients
Roots Community Health Center PastSince Jan 26, 2020 Accepting new patients

Locations

40910 Fremont Blvd
Fremont, CA 94538
Phone (510) 770-8133

1650 S White Rd
San Jose, CA 95127
Phone (408) 928-5250

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.

NPI Registry JSON

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1841820834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-19",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95193337",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.