Andrea Vittoria Shaw, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

281937 Issued in NY

Practice address

725 East Adams St.
4TH FL
Syracuse, NY 13210

Phone

(315) 464-5831

Fax

(315) 464-2030

NPI assigned

Apr 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Emergency Medicine, Internal Medicine

Education

State University of Ny Upstate Medical University, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr inGroup PAC ID 3274445796, 277 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: ashaw52997@direct.upstate.edu

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.

• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1063468239
  Medicare reassignment Care Compare group NPD
• Pediatric Service Group

  • Pediatrics Physician
  • Syracuse, NY
  • NPI 1770539066
  Medicare reassignment NPD
• Syracuse Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1497796353
  Medicare reassignment NPD
• Upstate Emergency Medicine, Inc

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1275589582
  Medicare reassignment NPD
• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD
• Syracuse Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1184886988
  NPD

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1912141904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 EAST ADAMS ST.",
            "address_2": "4TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5831",
            "fax_number": "315-464-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 EAST ADAMS ST.",
            "address_2": "4TH FL",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5831",
            "fax_number": "315-464-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ANDREA",
        "middle_name": "VITTORIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A124854",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A124854",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "281937",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "281937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04326707",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tala Shatila, M.A. CCC-SLP
• Mark Shaughnessy
• Al-Aman Shaukat, MD
• Mishal Shaukat, MD
• Coleen Teri Shaver
• Eric Gorgon Shaw, M.D.
• James Albert Shaw, M.D.
• Maizie Marie Shaw
• Mary Shaw, RN
• Melinda M Shaw, PA

• Internal Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.