| Dr David Jon Shaw, MD | |
|
12554 Riata Vista Cir, Austin, TX 78727-6431 | |
| (512) 795-5100 | |
| (512) 795-5122 |
| Full Name | Dr David Jon Shaw |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 19 Years |
| Location | 12554 Riata Vista Cir, Austin, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659375202 | NPI | - | NPPES |
| 167954002 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | L9478 (Texas) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD61493684 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence St Peter Hospital | Olympia, WA | Hospital |
| Olympic Medical Center | Port angeles, WA | Hospital |
| Providence Centralia Hospital | Centralia, WA | Hospital |
| Peacehealth Southwest Medical Center | Vancouver, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Sound Radiologists Inc P S | 1254229305 | 61 |
| Radia Imaging Center Holdings Llc | 6305182965 | 39 |
| Singleton Associates Pa | 6305731118 | 635 |
| Radia Inc P S | 9931012812 | 263 |
| Entity Name | Singleton Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538107875 PECOS PAC ID: 6305731118 Enrollment ID: O20040315000385 |
| Entity Name | Austin Radiological Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033196464 PECOS PAC ID: 4880686179 Enrollment ID: O20040330000453 |
| Entity Name | Medford Radiological Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407938111 PECOS PAC ID: 2062303324 Enrollment ID: O20201012002917 |
| Entity Name | Radia Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932196607 PECOS PAC ID: 9931012812 Enrollment ID: O20220902000393 |
| Entity Name | Evergreen Radia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922095694 PECOS PAC ID: 4587568076 Enrollment ID: O20221202000482 |
| Entity Name | South Sound Radiologists Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902990500 PECOS PAC ID: 1254229305 Enrollment ID: O20221203000061 |
| Entity Name | Swedish Radia Imaging Center At Edmonds Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164494373 PECOS PAC ID: 5496778292 Enrollment ID: O20221203000147 |
| Entity Name | Radia Imaging Center Holdings Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639653017 PECOS PAC ID: 6305182965 Enrollment ID: O20221205001634 |
| Entity Name | Central Washington Health Services Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881642239 PECOS PAC ID: 4880504596 Enrollment ID: O20230201000919 |
| Entity Name | Radia Oregon Radiology Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073385423 PECOS PAC ID: 2961852637 Enrollment ID: O20240129003506 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Jon Shaw, MD 12554 Riata Vista Cir, Austin, TX 78727-6431 Ph: (512) 795-5100 | Dr David Jon Shaw, MD 12554 Riata Vista Cir, Austin, TX 78727-6431 Ph: (512) 795-5100 |
Jason R. Wallace, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Gregory Connor, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Cir, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Catherine Suchia Wu, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 4101 James Casey Blvd, #100, Austin, TX 78745 Phone: 512-447-2202 Fax: 512-447-5337 | |
Dr. Michael Troy Harper, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Ian L. Love, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 8038 Mesa Dr, Austin, TX 78731 Phone: 512-901-8748 Fax: 512-901-8755 | |
Dr. Bradley Brenner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Cir, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Gordon A. Witwer, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 |