DR. SHANE E MACAULAY M.D.
NPI 1255353710
Radiology - Diagnostic Radiology in Bellevue, WA

NPI Status: Active since July 24, 2006

Contact Information

1310 116TH AVE NE
SUITE E
BELLEVUE, WA
ZIP 98004
Phone: (425) 250-1145
Fax: (425) 823-6028

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  • Individual
  • Male
  • Years of Experience 38
  • Radiology
  • Diagnostic Radiology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SHANE MACAULAY

This page provides the complete NPI Profile along with additional information for Shane Macaulay, a provider established in Bellevue, Washington with a medical specialization in Radiology, focusing in diagnostic radiology and more than 38 years of experience. He graduated from University Of California, San Diego School Of Medicine in 1988. The healthcare provider is registered in the NPI registry with number 1255353710 assigned on July 2006. The practitioner's primary taxonomy code is 2085R0202X with license number MD00027606 (WA). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1255353710
Provider Name
DR. SHANE E MACAULAY M.D.
Gender
Male
Entity Type
Individual
Location Address
1310 116TH AVE NE SUITE E BELLEVUE, WA 98004
Location Phone
(425) 250-1145
Location Fax
(425) 823-6028
Mailing Address
11811 NE 128TH ST SUITE 202 KIRKLAND, WA 98034
Mailing Phone
(425) 250-1145
Mailing Fax
(425) 823-6028
Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year
1988
Is Sole Proprietor?
No
Enumeration Date
07-24-2006
Last Update Date
02-28-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
MD00027606
License State
WA
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
F58147MEDICARE UPIN (02)WA 
8147266MEDICAID (05)WA 
215100303MEDICARE ID-TYPE UNSPECIFIED (04)WA 

Medicare Participation & PECOS Enrollment Status

Shane Macaulay is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Shane Macaulay is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 446272355

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20051220000511, I20240703000874

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Ct scan of leg without contrast

A CT scan of the leg is a non-invasive imaging test that uses X-rays to capture detailed images of your leg's bones, muscles, and blood vessels. It doesn't use contrast dye and doesn't cause any pain. It helps in diagnosing injuries or diseases.

This service was performed 38 times for 37 patients

Fluoroscopic guidance for needle placement

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

This service was performed 20 times for 20 patients

Injection of contrast for imaging of shoulder joint

This procedure involves injecting a contrast agent into your shoulder joint. The contrast helps highlight the joint on an imaging scan, giving a clearer picture of its condition. It can help identify any abnormalities or injuries. It's generally safe with minimal discomfort.

This service was performed 13 times for 13 patients

Injection, gadoterate meglumine, 0.1 ml

Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.

This service was performed 5,195 times for 43 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 1,146 times for 20 patients

Mri scan of arm joint with contrast

An MRI scan of your arm joint with contrast is a non-invasive imaging test. A safe dye is injected into your body to enhance the visibility of tissues and structures. It helps doctors diagnose conditions such as arthritis, tumors, or injuries. The procedure is painless.

This service was performed 11 times for 11 patients

Mri scan of arm joint without contrast

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

This service was performed 48 times for 47 patients

Mri scan of brain before and after contrast

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

This service was performed 13 times for 13 patients

Mri scan of brain without contrast

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

This service was performed 12 times for 12 patients

Mri scan of leg joint without contrast

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

This service was performed 70 times for 66 patients

Mri scan of leg without contrast

An MRI scan of the leg without contrast is a non-invasive imaging procedure. It uses a magnetic field and radio waves to create detailed images of the structures in your leg, such as bones, muscles, and blood vessels. No contrast dye is used.

This service was performed 18 times for 18 patients

Mri scan of lower spinal canal without contrast

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

This service was performed 43 times for 43 patients

Mri scan of upper spinal canal without contrast

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

This service was performed 11 times for 11 patients

X-ray of knee, 3 views

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

This service was performed 25 times for 15 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $24.35 for a new patient copayment and $19.68 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 98004 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $97.43
  • Minimum New Patient Price $63.67
  • Maximum New Patient Price $189.37
  • Average New Patient Copayment $24.35
  • Minimum New Patient Copayment $15.91
  • Maximum New Patient Copayment $47.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $78.74
  • Minimum Established Patient Price $21.12
  • Maximum Established Patient Price $155
  • Average Established Patient Copayment $19.68
  • Minimum Established Patient Copayment $5.28
  • Maximum Established Patient Copayment $38.75

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1255353710, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
3
Doubled → 6
Pos 6
5
Unchanged
Pos 7
3
Doubled → 6
Pos 8
7
Unchanged
Pos 9
1
Doubled → 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 3 → 6 3 → 6 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 6 + 5 + 6 + 7 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1255353710.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Internal Medicine (Rheumatology)
1310 116TH AVE NE, STE C
BELLEVUE, WA 98004
Internal Medicine (Rheumatology)
1310 116TH AVE NE, STE C
BELLEVUE, WA 98004
Specialist
1310 116TH AVE NE, SUITE A
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Family Medicine
1310 116TH AVE NE, SUITE A
BELLEVUE, WA 98004
Chiropractor
1310 116TH AVE NE, SUITE A
BELLEVUE, WA 98004
Pain Medicine (Pain Medicine)
1310 116TH AVE NE
BELLEVUE, WA 98004
Radiology (Diagnostic Radiology)
1310 116TH AVE NE, SUITE E
BELLEVUE, WA 98004
Specialist
1310 116TH AVE NE, #C
BELLEVUE, WA 98004

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255353710, enumerated as an "individual" on July 24, 2006.

The provider is located at 1310 116TH AVE NE SUITE E BELLEVUE, WA 98004 and the phone number is (425) 250-1145.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.