P MICHAEL SHATTUCK MD
NPI 1740273630
Emergency Medicine in Berlin, WI
About P Michael Shattuck Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
P MICHAEL SHATTUCK MD (NPI 1740273630) is an individual emergency medicine provider in Berlin, Wisconsin, licensed in Wisconsin (25430) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Wautoma.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
P Michael Shattuck Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show P Shattuck reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Berlin, WI 54923
- Reassigned Medicare billing, Wisconsin enrollment
- 104 clinicians in this Medicare group
New London, WI 54961
- Reassigned Medicare billing, Wisconsin enrollment
- 988 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54923 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 P Shattuck's NPI number?
The NPI number for P Shattuck is 1740273630. It was assigned to this individual provider in the NPPES registry on August 25, 2005. The provider is also known as Paul Shattuck MD.
Where is P Shattuck located?
P Shattuck practices at 225 Memorial Dr, Berlin, WI 54923. The listed phone number is (920) 361-5538.
What is P Shattuck's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is P Shattuck enrolled in Medicare?
Yes. P Shattuck is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for P Shattuck's services?
According to the CMS Revalidation Reassignment List (October 2026 release), P Shattuck reassigns Medicare benefits to 2 organizations: Thedacare Medical Center - Berlin, Inc. (Berlin, WI) and Thedacare, Incorporated (New London, WI). Each 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 P Shattuck's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does P Shattuck accept?
Health plans from Anthem Blue Cross and Blue Shield list P Shattuck as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for P Shattuck was last updated on July 26, 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.
# P Michael Shattuck, MD · NPI 1740273630
Emergency Medicine physician in Berlin, Wisconsin. Individual provider, active in the CMS NPPES registry since August 25, 2005.
## Identity
- **NPI:** 1740273630 (Entity type: Individual)
- **Enumerated:** August 25, 2005
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 25430 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 225 MEMORIAL DR, Berlin, WI 54923-1243
- **Phone:** (920) 361-5538 · **Fax:** (920) 361-5499
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Thedacare Medical Center - Berlin, Inc. (NPI 1760413777, Berlin, WI); Thedacare, Incorporated (NPI 1376656959, New London, WI) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 26, 2023
- **Other identifiers:** Medicaid 30668600 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1740273630) · Data from the CMS NPPES public registry.