Individual provider Active NPI

Robin L Shaw, ANP

  • Adult Health Nurse Practitioner
  • Spencerport, NY
National Provider Identifier
1902822893
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300952 Issued in NY
Practice address
42 Nichols Street
Spencerport, NY 14559
Phone
(585) 637-7558
Fax
(585) 637-7566
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300952 NY Primary

Addresses

Primary practice location

42 Nichols Street
Spencerport, NY 14559

Mailing address

42 Nichols Street
Spencerport, NY 14559
Phone (585) 637-7558

Other identifiers 6

IdentifierTypeStateIssuer
000560051002OtherNYCOMMUNITY BLUE
00010009201OtherUNIVERA
005605512OtherNYBCBS WESTERN NY
P010000065OtherNYBCBS ROCHESTER
109177BJOtherPREFERRED CARE
9511861OtherINDEPENDENT HEALTH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111107000059 NY Practitioner - Nurse Practitioner 0648443895 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F300952NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Aug 1, 2016 Accepting new patients
University of Rochester CurrentSince Aug 1, 2016 Accepting new patients

Locations

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

155 Corporate Woods
Ste 100
Rochester, NY 14623
Phone (585) 784-7864

42 Nichols St
Spencerport, NY 14559
Phone (585) 349-7094

Interoperability endpoints

  • Direct secure messaging: rshaw107790@direct.urmc.rochester.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1902822893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NICHOLS STREET",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-637-7558",
            "fax_number": "585-637-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NICHOLS STREET",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-637-7558",
            "fax_number": "585-637-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROBIN",
        "middle_name": "L",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000560051002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010009201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WESTERN NY",
            "identifier": "005605512",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ROCHESTER",
            "identifier": "P010000065",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "109177BJ",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9511861",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencerport, NY

Sources for this page

Verify at the official NPI Registry.