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SHANE ALAN DAUGHERTY
NPI 1154902096
Urology in Meadville, PA

Active since April 20, 2021PECOS EnrolledAccepts Medicare Assignment
765 LIBERTY ST STE 207A, MEADVILLE, PA 16335(814) 373-2156(814) 373-2159 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Shane Alan Daugherty NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE ALAN DAUGHERTY (NPI 1154902096) is an individual urology provider in Meadville, Pennsylvania, licensed in Pennsylvania (OS026090) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Meadville Medical Center, and maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1154902096
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameSHANE ALAN DAUGHERTY
Location Address765 LIBERTY ST STE 207AMeadville, PA 16335-2568
Mailing Address1034 Grove StMeadville, PA 16335-2945 · (814) 373-2156 · Fax (814) 373-2159
Phone(814) 373-2156
Fax(814) 373-2159
Sole ProprietorYes
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2021
Enumeration DateApril 20, 2021
Last NPPES UpdateJune 30, 2026
NPPES CertifiedJune 30, 2026
✔ NPI 1154902096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in PA · OS026090
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
765 LIBERTY ST STE 207A, Meadville, PA 16335
Open in Google Maps ↗

Secondary Practice Location 1

Location 14160 John R St Ste 1017Detroit, MI 48201-2017 · Phone (313) 745-4123

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shane Alan Daugherty is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577963909
PECOS Enrollment IDI20260714005237
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shane Daugherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Meadville Medical Center
Same address
Urology
765 LIBERTY ST STE 207A
Meadville, PA 16335
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 4 clinicians in this Medicare group
NPI 1841782869 (814) 373-2156

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Meadville Medical Center

Acute Care Hospitals · Meadville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390113
Location751 Liberty StreetMeadville, PA 16335 · Crawford County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELSEY M SNYDER PA-C
Physician Assistant (Medical)
765 LIBERTY ST STE 207A
MEADVILLE, PA 16335
Crawford County (814) 373-2156
MARIE LYNN JOHNSON PA-C
Physician Assistant
765 LIBERTY ST STE 207A
MEADVILLE, PA 16335
Crawford County (814) 373-2156
MEADVILLE MEDICAL CENTER
Urology
765 LIBERTY ST STE 207A
MEADVILLE, PA 16335
Crawford County (814) 373-2156

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Daugherty's NPI number?

The NPI number for Shane Daugherty is 1154902096. It was assigned to this individual provider in the NPPES registry on April 20, 2021.

Where is Shane Daugherty located?

Shane Daugherty practices at 765 Liberty St Ste 207A, Meadville, PA 16335. The listed phone number is (814) 373-2156.

What is Shane Daugherty's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Shane Daugherty enrolled in Medicare?

Yes. Shane Daugherty is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shane Daugherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Daugherty reassigns Medicare benefits to Meadville Medical Center (Meadville, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Daugherty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Shane Daugherty affiliated with any hospitals?

According to CMS data, Shane Daugherty is affiliated with Meadville Medical Center.

When was this NPI record last updated?

The NPPES record for Shane Daugherty was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.