Patti Wannetta Shaw, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3601 Issued in OK

Practice address

9228 S. Mingo
Suite 103
Tulsa, OK 74133-5721

Phone

(918) 392-7575

Fax

(918) 615-3465

NPI assigned

Jul 4, 2006

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 OK

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

Internal Medicine

Education

Oklahoma State University College of Osteopathic Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pshaw112960@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group, LLC

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD

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

• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1962432757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "STE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-392-7575",
            "fax_number": "918-615-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 S. MINGO",
            "address_2": "SUITE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335721",
            "telephone_number": "918-392-7575",
            "fax_number": "918-615-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PATTI",
        "middle_name": "WANNETTA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100132300A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaron Lavell Shaw
• Mariesha R Shaw
• Michael B Shaw, D.O.
• Mimi Mary Shaw, O.T.
• Parker T Shaw, PH.D.
• Piper Shaw
• Tara Javon Shaw, BS
• Tiffani Shaw
• Timothy Joshua Shaw
• Victoria Rose Shaw

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.