NPIMap

Individual provider Active NPI

Lauren Yetzer Shaver, PA-C

  • Physician Assistant
  • Emporium, PA
National Provider Identifier
1962773606
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055289 Issued in PA
Practice address
90 E 2ND St
Emporium, PA 15834-1302
Phone
(814) 486-1115
Fax
(814) 486-0404
NPI assigned
Jan 25, 2012
Last updated
Dec 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002769 PA
Physician Assistant 363A00000X MA055289 PA Primary

Addresses

Primary practice location

90 E 2ND St
Emporium, PA 15834-1302

Mailing address

90 E 2ND St
Emporium, PA 15834-1302
Phone (814) 486-1115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120521000208 PA Practitioner - Physician Assistant 2264695758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

49 Ridgmont Dr
Suite 1
Ridgway, PA 15853-9700
Phone (814) 245-2119

90 E 2ND St
Emporium, PA 15834-1302
Phone (814) 486-1115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Rural Health Consortia, Inc. CurrentSince Nov 7, 2017 Accepting new patients
Dubois Regional Medical Center Physician Assistant Current Accepting new patients
Dubois Regional Medical Group, PC Physician Assistant Past Accepting new patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients
Keystone Rural Health Consortia Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

90 E 2nd St
Emporium, PA 15834
Phone (814) 486-0909

118 N Fraley St
Kane, PA 16735
Phone (814) 837-6313

49 Ridgmont Dr
#1
Ridgway, PA 15853
Phone (814) 245-2119

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1962773606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E 2ND ST",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341302",
            "telephone_number": "814-486-1115",
            "fax_number": "814-486-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E 2ND ST",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341302",
            "telephone_number": "814-486-1115",
            "fax_number": "814-486-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "LAUREN",
        "middle_name": "YETZER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002769",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporium, PA

Sources for this page

Verify at the official NPI Registry.