Jaclyn Shaw, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

010310-1 Issued in NY

Practice address

1044 State St
Schenectady, NY 12307-1508

Phone

(518) 370-1441

Fax

(518) 395-9431

NPI assigned

Feb 24, 2006

Last updated

Jul 21, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John M Pramenko MD PCGroup PAC ID 8921193566, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• John M. Pramenko, MD, P.C.

  • Family Medicine Physician
  • Niskayuna, NY
  • NPI 1821293309
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1891761474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071508",
            "telephone_number": "518-370-1441",
            "fax_number": "518-395-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071508",
            "telephone_number": "518-370-1441",
            "fax_number": "518-395-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JACLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "010310-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hedva Shamir, MD
• Kathleen Shanley, MD
• Preshi Shanmugathasan, M.D.
• Erin Catherine Shannon, FNP-BC
• Jennifer Shattuck
• Shawn Allen DDS, PC
• Gabrielle Shea, LPN
• Margaret A Sheaffer
• Shulamit K. Shechter, RDN, CDCES
• Devin Ryan Sheehan

• Family Medicine Physician in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.

Verify at the official NPI Registry.