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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CONNIE SHAO
NPI 1356848865
Colon & Rectal Surgery in Grand Rapids, MI

Active since April 11, 2018PECOS Enrolled
4100 LAKE DR SE, GRAND RAPIDS, MI 49546(616) 267-7100 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 31, 2026, Apr 11, 2018 (2 updates tracked since 2018).

About Connie Shao NPPES

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

CONNIE SHAO (NPI 1356848865) is an individual colon & rectal surgery provider in Grand Rapids, Michigan, licensed in Michigan (4301516933) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of University Of Chicago, Pritzker School Of Medicine (2018).

NPPES Registry Identity

NPI1356848865
Entity TypeIndividualFemale
Primary Taxonomy208C00000X
Provider Legal NameCONNIE SHAO
Location Address4100 LAKE DR SEGrand Rapids, MI 49546-8292
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 267-7100
Sole ProprietorNo
Medical School CMSUniversity Of Chicago, Pritzker School Of MedicineGraduated 2018
Enumeration DateApril 11, 2018
Last NPPES UpdateAugust 31, 20262 updates tracked since enumeration
NPPES CertifiedAugust 31, 2026
✔ NPI 1356848865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in MI · 4301516933
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
4100 LAKE DR SE, Grand Rapids, MI 49546
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connie Shao is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991216715
PECOS Enrollment IDI20260708004543
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 20

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

TELLA KATARINA MINKKINEN PT
Physical Therapist
4100 LAKE DR SE, SUITE 305
GRAND RAPIDS, MI 49546
Kent County (616) 285-1377
RANDALL SCOTT MEISNER MD
Internal Medicine (Gastroenterology)
4100 LAKE DR SE, SUITE 205
GRAND RAPIDS, MI 49546
Kent County (616) 267-7414
DR. MARYKAY LEHMAN M.D.
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 949-8244
GUSTAVO CUMBO-NACHELI
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 267-8244
JANET DOMINOWSKI RD
Dietitian, Registered
4100 LAKE DR SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 267-8950
WALTER M BRAUNOHLER M.D.
Orthopaedic Surgery
4100 LAKE DR SE, SUITE 300
GRAND RAPIDS, MI 49546
Kent County (616) 267-8860
JILL C THORPE PA-C
Physician Assistant
4100 LAKE DR SE, SUITE 205
GRAND RAPIDS, MI 49546
Kent County (616) 774-2414
PATRICIA BEGGS AT, ATC
Specialist/Technologist (Athletic Trainer)
4100 LAKE DR SE, SUITE 300
GRAND RAPIDS, MI 49546
Kent County (616) 267-8565

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 Connie Shao's NPI number?

The NPI number for Connie Shao is 1356848865. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Where is Connie Shao located?

Connie Shao practices at 4100 Lake Dr SE, Grand Rapids, MI 49546. The listed phone number is (616) 267-7100.

What is Connie Shao's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Connie Shao enrolled in Medicare?

Yes. Connie Shao is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Connie Shao was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.