Michael Ed Shaw

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055.0031417 Issued in VT

Practice address

130 Fisher Rd Unit 1
Berlin, VT 05602-8132

Phone

(802) 371-4264

NPI assigned

Oct 31, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshaw235894@direct.uvmhealth.org

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.

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784

  VT

  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  • Internal Medicine Physician
  • Berlin, VT
  • NPI 1831374362

  VT

  Medicare reassignment NPD
• Porter Hospital Inc

  • Critical Access Hospital
  • Middlebury, VT
  • NPI 1740291400

  VT

  Medicare reassignment NPD
• Porter Hospital, Inc

  • Family Medicine Physician
  • Middlebury, VT
  • NPI 1134457013

  VT

  Medicare reassignment NPD
• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615

  VT

  Medicare reassignment NPD

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1861969412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD UNIT 1",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056028132",
            "telephone_number": "802-371-4264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 Barre-Montpelier Road",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "VT",
            "postal_code": "05602",
            "country_code": "US",
            "telephone_number": "802-671-4239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 Lakeview Ter # 2",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054012930",
            "country_code": "US",
            "telephone_number": "802-343-1377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Porter Dr",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "VT",
            "postal_code": "057538629",
            "country_code": "US",
            "telephone_number": "802-388-4430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MICHAEL",
        "middle_name": "ED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-31",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sas Gastroenterology LLC
• Hilari Shae Sauncy, MD
• Richmond Xavier Scott, LCMHC
• David Alexander Segel, FNP
• Marc Allen Semprebon, PHARMD
• Shaws Supermarkets Inc
• Harriott Meyer Shea, MD
• Jessica Shedd, FNP-BC
• Holly D. Shephard, LCMHC
• Jessica R Sherman, AGPCNP-BC

• All providers in Berlin, VT
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.