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KRISTIAN TAYLOR SHAW PA-C
NPI 1477112381
Physician Assistant - Medical in Lakewood, OH

Active since June 13, 2019PECOS EnrolledAccepts Medicare Assignment
14601 DETROIT AVE, LAKEWOOD, OH 44107(216) 237-5500 Get Directions Write a Review

NPPES record last updated: May 10, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 10, 2023, Jun 13, 2019 (2 updates tracked since 2019).

About Kristian Taylor Shaw Pa-c NPPES

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

KRISTIAN TAYLOR SHAW PA-C (NPI 1477112381) is an individual medical provider in Lakewood, Ohio and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Cleveland Clinic, and maintains a secondary practice location in Crystal Lake.

NPPES Registry Identity

NPI1477112381
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKRISTIAN TAYLOR SHAWCredential: PA-C
Location Address14601 DETROIT AVELakewood, OH 44107-4205
Mailing Address828 Waterford CutCrystal Lake, IL 60014-8506
Phone(216) 237-5500
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJune 13, 2019
Last NPPES UpdateMay 10, 20232 updates tracked since enumeration
NPPES CertifiedJune 7, 2022
✔ NPI 1477112381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Also ListedBehavior TechnicianTaxonomy 106S00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
14601 DETROIT AVE, Lakewood, OH 44107
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Secondary Practice Location 1

Location 1828 Waterford CutCrystal Lake, IL 60014-8506 · Phone (847) 306-9843

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristian Taylor Shaw Pa-c 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 ID7810358520
PECOS Enrollment IDI20230727002682
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
459 services88 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
213 services199 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
152 services139 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
130 services120 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
102 services97 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
86 services84 patients

Hospital Affiliations CMS Care Compare

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

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

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.

JULIA LACOMB DO
Student in an Organized Health Care Education/Training Program
14601 DETROIT AVE
LAKEWOOD, OH 44107
Cuyahoga County (216) 237-5500
DR. NAZIH M ZEIN M.D.
Internal Medicine (Rheumatology)
14601 DETROIT AVE, 590
LAKEWOOD, OH 44107
Cuyahoga County (216) 529-7098
ARTHUR PETER DICK MD
Psychiatry & Neurology (Neurology)
14601 DETROIT AVE, SUITE 480
LAKEWOOD, OH 44107
Cuyahoga County (216) 529-7090
MARY ANN SANTUCCI MD
Student in an Organized Health Care Education/Training Program
14601 DETROIT AVE
LAKEWOOD, OH 44107
Cuyahoga County (216) 237-5500
DR. HAREENDRA G. ADHVARYU M.D.
Psychiatry & Neurology (Psychiatry)
14601 DETROIT AVE, SUITE 690
LAKEWOOD, OH 44107
Cuyahoga County (216) 529-2359
DR. MARIA ROLLINGER DO
Student in an Organized Health Care Education/Training Program
14601 DETROIT AVE
LAKEWOOD, OH 44107
Cuyahoga County (216) 237-5500
MRS. CHRISTINE ANN DEARTH CNP
Nurse Practitioner
14601 DETROIT AVE, SUITE 540
LAKEWOOD, OH 44107
Cuyahoga County (216) 529-5300
WHIT RYAN PSYD
Psychologist (Clinical Child & Adolescent)
14601 DETROIT AVE
LAKEWOOD, OH 44107
Cuyahoga County (216) 237-5500

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 Kristian Shaw's NPI number?

The NPI number for Kristian Shaw is 1477112381. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Where is Kristian Shaw located?

Kristian Shaw practices at 14601 Detroit Ave, Lakewood, OH 44107. The listed phone number is (216) 237-5500.

What is Kristian Shaw's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kristian Shaw enrolled in Medicare?

Yes. Kristian Shaw 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.

Is Kristian Shaw affiliated with any hospitals?

According to CMS data, Kristian Shaw is affiliated with Cleveland Clinic.

When was this NPI record last updated?

The NPPES record for Kristian Shaw was last updated on May 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.