Active NPI
Roxana Shaw, MPAS, P.A.-C, CHC
- Physician Assistant
- Newport Beach, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA55445
- Practice address
- 3991 Macarthur Blvd Ste 200
Newport Beach, CA 92660-3048 - Phone
- (949) 887-7187
- Fax
- (949) 553-4136
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005335-1 | NY | |
| Physician Assistant | 363A00000X | PA55445 | CA | Primary |
Addresses
Primary practice location
3991 Macarthur Blvd Ste 200
Newport Beach, CA 92660-3048
Mailing address
4232 Albany Post Rd
Hyde Park, NY 12538-1766
Phone (845) 229-8977
Other practice location 1
4232 Albany Post Rd
Hyde Park, NY 12538-1766
Phone (845) 229-8977
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
655 Redwood Hwy Frontage Rd
Suite 246
Mill Valley, CA 94941-3055
Phone (702) 848-2256
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA55445 | CA | MD | Physician Assistant |
| 005335-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anywhere Clinic PC | Physician Assistant | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Past | Accepting new patients | |
| Trustees of Columbia University Dept of Obstetrics and Gynecology | Past | Accepting new patients |
Locations
655 Redwood Hwy Frontage Rd
Ste 246
Mill Valley, CA 94941
Phone (415) 301-5000
4029 Dean Martin Dr
Las Vegas, NV 89103
Phone (702) 919-1508
Organizations & group practices 4
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.
-
- Obstetrics & Gynecology Physician
- New York, NY
- NPI 1154346021
-
- Pediatric Emergency Medicine (Pediatrics) Physician
- New York, NY
- NPI 1760444822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1851467013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4232 ALBANY POST RD",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "125381766",
"telephone_number": "845-229-8977",
"fax_number": "845-229-8930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3991 MACARTHUR BLVD STE 200",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926603048",
"telephone_number": "949-887-7187",
"fax_number": "949-553-4136"
}
],
"practiceLocations": [
{
"address_1": "4232 Albany Post Rd",
"address_purpose": "LOCATION",
"city": "Hyde Park",
"state": "NY",
"postal_code": "125381766",
"country_code": "US",
"telephone_number": "845-229-8977",
"fax_number": "845-229-8930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAW",
"first_name": "ROXANA",
"name_prefix": "Ms.",
"credential": "MPAS, P.A.-C, CHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005335-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA55445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.