Shad Fredrick Crapo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

195 Feather Way
Evanston, WY 82930-9352

Phone

(307) 200-9200

NPI assigned

Nov 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment Care Compare group NPD
• CC Pocatello LLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1538517156
  Medicare reassignment
• Community Care West Side LLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1295009785
  Medicare reassignment
• Community Care

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1790708832
  NPD
• Community Care Pocatello PLLC

  • Urgent Care Clinic/Center
  • Pocatello, ID
  • NPI 1265714760
  NPD
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)

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

• Madison Co Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1912476649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FEATHER WAY",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FEATHER WAY",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309352",
            "telephone_number": "307-200-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAPO",
        "first_name": "SHAD",
        "middle_name": "FREDRICK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Cooper, RN
• Joshua Robert Cosgrave, MSW, PCSW
• County of Uinta
• County of Uinta
• Marjorie M Coyle
• D McKay Francom DDS
• David R Russell OD
• Davidson Chiropractic Clinic - Evanston LLC
• Carol Diane Davis, OTR/L
• Kenneth Casey Davis, D.C.

• Physician Assistant in Evanston, WY
• Providers in Evanston, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.