Jeffrey L Shaw, MD is a medicare enrolled "Allergy & Immunology" physician in Green Bay, Wisconsin. He graduated from medical school in 1997 and has 28 years of diverse experience with area of expertise as Allergy/immunology. He is a member of the group practice St Vincent Hospital-hospital Sisters-third Order Of St Francis, St. Nicholas Hospital-sisters Of The Third Order Of St Francis and his current practice location is
1821 S Webster Ave, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 496-4700.
Jeffrey L Shaw is licensed to practice in Wisconsin (license number 42113-020) 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 1124083712.
Physician's Profile
| Full Name | Jeffrey L Shaw |
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| Gender | Male |
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| Speciality | Allergy/immunology |
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| Experience | 28 Years |
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| Location | 1821 S Webster Ave, Green Bay, Wisconsin |
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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:
- Jeffrey L Shaw graduated from medical school in 1997
NPI Data:
- NPI Number: 1124083712
- Provider Enumeration Date: 04/18/2006
- Last Update Date: 01/12/2017
Medicare PECOS Information:
- PECOS PAC ID: 8628105160
- Enrollment ID: I20121009000293
Medical Identifiers
Medical identifiers for Jeffrey L Shaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124083712 | NPI | - | NPPES |
| 2324505 | Medicaid | OH | |
| 1840670000 | Medicaid | WV | |
| 64049158 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207K00000X | Allergy & Immunology | 20844 (West Virginia) | Secondary |
| 207K00000X | Allergy & Immunology | 42113-020 (Wisconsin) | Primary |
| 208000000X | Pediatrics | 20884 (West Virginia) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| St Vincent Hospital-hospital Sisters-third Order Of St Francis | 5799694675 | 567 |
| St. Nicholas Hospital-sisters Of The Third Order Of St Francis | 8325931652 | 157 |
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. Jeffrey L Shaw allows following entities to bill medicare on his behalf.
| Entity Name | St. Nicholas Hospital-sisters Of The Third Order Of St Francis |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275799413
PECOS PAC ID: 8325931652
Enrollment ID: O20040202001172 |
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| Entity Name | St Vincent Hospital-hospital Sisters-third Order Of St Francis |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285613638
PECOS PAC ID: 5799694675
Enrollment ID: O20080620000423 |
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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. Jeffrey L 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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Jeffrey L Shaw, MD
Po Box 19070,
Green Bay, WI 54307-9070
Ph: (920) 496-4700 | Jeffrey L Shaw, MD
1821 S Webster Ave,
Green Bay, WI 54301
Ph: (920) 496-4700 |
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