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ANDY SHAO
NPI 1972252765
Student in an Organized Health Care Education/Training Program in Sacramento, CA

Active since March 21, 2022PECOS Enrolled
4860 Y ST STE 2400, SACRAMENTO, CA 95817(916) 734-6602 Get Directions Write a Review

NPPES record last updated: March 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Andy Shao NPPES

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

ANDY SHAO (NPI 1972252765) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972252765
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDY SHAO
Location Address4860 Y ST STE 2400Sacramento, CA 95817-2307
Mailing Address4860 Y St Ste 2400Sacramento, CA 95817-2307 · (916) 734-6602
Phone(916) 734-6602
Sole ProprietorYes
Enumeration DateMarch 21, 2022
NPPES CertifiedMarch 21, 2022
✔ NPI 1972252765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4860 Y ST STE 2400, Sacramento, CA 95817
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Andy Shao reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
38 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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. JEFFREY RYUTA WILLIS M.D., PHD
Student in an Organized Health Care Education/Training Program
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
ANDREW XIE CHEN
Student in an Organized Health Care Education/Training Program
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
MICHAEL NGUYEN MD
Student in an Organized Health Care Education/Training Program
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
CLAYTON GRUNDVIG MD
Student in an Organized Health Care Education/Training Program
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
JONATHAN HERNANDEZ
Ophthalmology
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
ALEXANDER RUSAKEVICH DO
Student in an Organized Health Care Education/Training Program
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6602
DR. YIN LIU M.D., PH.D.
Ophthalmology (Neuro-ophthalmology)
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (916) 734-6891
CRISTY KU M.D., PH.D.
Ophthalmology
4860 Y ST STE 2400
SACRAMENTO, CA 95817
Sacramento County (503) 494-8386

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 Andy Shao's NPI number?

The NPI number for Andy Shao is 1972252765. It was assigned to this individual provider in the NPPES registry on March 21, 2022.

Where is Andy Shao located?

Andy Shao practices at 4860 Y St Ste 2400, Sacramento, CA 95817. The listed phone number is (916) 734-6602.

What is Andy Shao's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Andy Shao enrolled in Medicare?

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

Which organization bills Medicare for Andy Shao's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andy Shao reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The 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 Andy Shao's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andy Shao was last updated on March 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.