Individual provider Active NPI

Shaun Michael York, MD

  • Emergency Medicine Physician
  • Tyler, TX
National Provider Identifier
1902032162
Registry record updated Oct 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N7666 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 531-4262
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N7666 TX Primary
Family Medicine Physician 207Q00000X BP10035372 TX
Family Medicine Physician 207Q00000X N7666 TX

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000

Other identifiers 12

IdentifierTypeStateIssuer
75-0818167-048OtherTXTRICARE
75-0818167-015OtherTXTRICARE
283376614MedicaidTX
75-2616977-001OtherTXTGRICARE
75-2616977-028OtherTXTRICARE
283376613MedicaidTX
283376615MedicaidTX
75-0818167-022OtherTXTRICARE
75-2616977-002OtherTXTRICARE
283376616MedicaidTX
75-1976930-005OtherTXTRICARE
75-0818167-044OtherTXTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000523 TX Practitioner - Emergency MedicinePractitioner - Family Practice 4183893316 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

1509 S Palestine St
Athens, TX 75751-8950
Phone (903) 675-6909

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital- Winnsboro Hospital, Winnsboro, TX, CCN 451381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7666TXMDEmergency Medicine Physician
BP10035372TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Jacksonville CurrentSince Jul 13, 2015 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 13, 2015 Accepting new patients
Northeast Texas Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 5, 2023 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Jul 13, 2015 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jul 13, 2015 Accepting new patients
East Texas Medical Center-Clarksville Past Accepting new patients

Locations

1509 State Highway 19 S
Athens, TX 75751
Phone (903) 606-4262

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: syork109777@christushealth.direct-ci.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446249600000",
    "number": "1902032162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-531-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "SHAUN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2015-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N7666",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10035372",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
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            "license": "N7666",
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        }
    ],
    "identifiers": [
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            "desc": "Other (non-Medicare)",
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        },
        {
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            "desc": "Other (non-Medicare)",
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            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
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            "identifier": "283376614",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TGRICARE",
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            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
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        },
        {
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            "issuer": null,
            "identifier": "283376613",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283376615",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283376616",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-1976930-005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-044",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.