Richard B Shore II, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10002567A Issued in IN

Practice address

2401 W University Ave
Muncie, IN 47303-3428

Phone

(765) 751-1720

Fax

(765) 741-2961

NPI assigned

Sep 11, 2018

Last updated

Feb 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rshore4@direct.iuhealth.org
• Direct secure messaging: rshore42590@direct.eskenazihealth.edu

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.

• Eskenazi Medical Group Inc

  • Adult Medicine Physician
  • Indianapolis, IN
  • NPI 1730451063

  Medical

  Medicare reassignment NPD
• Indiana University Health Urgent Care Centers, LLC.

  dba IU Health Urgent Care LLC

  • Urgent Care Clinic/Center
  • Greenwood, IN
  • NPI 1750763819
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1285103671
  Medicare reassignment
• Indiana Clinic Critical Care LLC

  • Pulmonary Disease Physician
  • Indianapolis, IN
  • NPI 1417285230
  Medicare reassignment
• Indiana University Health Care Associates, Inc

  dba IU Health Physicians

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment
• The Health and Hospital Corporation of Marion County

  dba Eskenazi Health

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1104027879
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Plymouth, IN
  • NPI 1336948629
  NPD
• Eskenazi Medical Group Inc

  dba Lifestyle Medicine Clinic

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Indianapolis, IN
  • NPI 1811407729
  NPD
• Indiana University Health Urgent Care Centers, LLC

  dba IU Health Urgent Care Centers, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1972273654
  NPD
• The Health and Hospital Corporation of Marion County

  dba Eskenazi Health

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1841855897
  NPD
• The Health and Hospital Corporation of Marion County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1871311779
  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1972086437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-751-1720",
            "fax_number": "765-741-2961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Ronald Reagan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461237085",
            "country_code": "US",
            "telephone_number": "317-217-3000",
            "fax_number": "317-963-5492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "RICHARD",
        "middle_name": "B",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002567A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002567A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001209830",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300018762",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P02264852",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshore4@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2401 W University Ave",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473033428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshore42590@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "5515 W 38th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462542919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshore4@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1111 Ronald Reagan Pkwy",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461237085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Haley Shipley
• David J. Shock
• Paula Denise Shockley, LPN
• Garrett Kenworthy Shook
• Lexus Lynn Shore
• Anna Shores
• Jilliann Lea Short, PHARM D
• Logan Paul Short
• Riley Michelle Showalter
• Thomas Shrack, PHARMD

• Medical Physician Assistant in Muncie, IN
• Providers in Muncie, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.