Dr Tavis M Shaw, DO is a medicare enrolled "Urology" physician in Wpafb, Ohio. He graduated from medical school in 2003 and has 23 years of diverse experience with area of expertise as Urology. He is a member of the group practice Alaska Native Tribal Health Consortium and his current practice location is
4881 Sugar Maple Dr, Wpafb, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 257-9292.
Dr Tavis M Shaw is licensed to practice in Utah (license number 14235720-1204) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871662809.
Physician's Profile
| Full Name | Dr Tavis M Shaw |
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| Gender | Male |
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| Speciality | Urology |
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| Experience | 23 Years |
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| Location | 4881 Sugar Maple Dr, Wpafb, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Tavis M Shaw graduated from medical school in 2003
NPI Data:
- NPI Number: 1871662809
- Provider Enumeration Date: 11/06/2006
- Last Update Date: 05/20/2026
Medicare PECOS Information:
- PECOS PAC ID: 9638113921
- Enrollment ID: I20170830000089
Medical Identifiers
Medical identifiers for Dr Tavis M Shaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871662809 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | OS013233 (Pennsylvania) | Secondary |
| 208800000X | Urology | 34.009996 (Ohio) | Secondary |
| 208800000X | Urology | 14235720-1204 (Utah) | Primary |
| 208600000X | Surgery | OS013233 (Pennsylvania) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Alaska Native Tribal Health Consortium | 6709780265 | 608 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tavis M Shaw allows following entities to bill medicare on his behalf.
| Entity Name | Southeast Alaska Regional Health Consortium |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376758037
PECOS PAC ID: 1456265362
Enrollment ID: O20031114000631 |
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| Entity Name | Alaska Native Tribal Health Consortium |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437189339
PECOS PAC ID: 6709780265
Enrollment ID: O20031125000772 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tavis M Shaw is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Tavis M Shaw, DO
Po Box 27128,
Salt Lake City, UT 84127-0128
Ph: () - | Dr Tavis M Shaw, DO
4881 Sugar Maple Dr,
Wpafb, OH 45433-5529
Ph: (937) 257-9292 |
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