AUSTIN JAMES SHACKELFORD DMD
NPI 1558864140
Dentist - Oral and Maxillofacial Pathology in Wilkes Barre, PA

Q: What is Austin Shackelford's NPI number?

The NPI number for Austin Shackelford is 1558864140. It was assigned to this individual provider in the NPPES registry on March 9, 2018.

Q: What is Austin Shackelford's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

Active since March 09, 2018PECOS EnrolledAccepts Medicare Assignment

675 BALTIMORE DR, WILKES BARRE, PA 18702(570) 808-5626(570) 808-6352 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 15, 2025, Oct 12, 2021, Mar 9, 2018 (3 updates tracked since 2018).

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About Austin James Shackelford Dmd NPPES

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

AUSTIN JAMES SHACKELFORD DMD (NPI 1558864140) is an individual oral and maxillofacial pathology provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (DS045082) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Geisinger Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1558864140

Entity TypeIndividualMale

Primary Taxonomy1223P0106X

Provider Legal NameAUSTIN JAMES SHACKELFORDCredential: DMD

Location Address675 BALTIMORE DRWilkes Barre, PA 18702-7900

Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 808-5626 · Fax (570) 808-6352

Phone(570) 808-5626

Fax(570) 808-6352

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateMarch 9, 2018

Last NPPES UpdateAugust 15, 20253 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1558864140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers

Taxonomy Code1223P0106X

License✔ Licensed in PA · DS045082

Definition

The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.

675 BALTIMORE DR, Wilkes Barre, PA 18702

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Austin James Shackelford Dmd 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 ID941548648

PECOS Enrollment IDI20250917004479

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.

Hospital Affiliations CMS Care Compare 2

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

Geisinger Medical Center

Acute Care Hospitals · Danville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390006

Location100 North Academy AvenueDanville, PA 17822 · Montour County

Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390270

Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18702 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

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 20

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

DR. KYLE BRYAN FRAZIER DDS

Dentist (Oral and Maxillofacial Surgery)