DOMINIQUE M SHAW (M.D.) – Obstetrics & Gynecology Physician, NPI 1871544536
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,008 OBSTETRICS/GYNECOLOGY in CA
Provider Addresses for DOMINIQUE M SHAW (M.D.)
11370 Anderson St
3900
Loma Linda, CA 923543450
Phone: (909) 370-3587
Type: Location
7717B 247TH ST
BELLEROSE, NY 114261830
Phone: (310) 600-8263
Type: Mailing
NYC Health + Hospitals/Gotham Health, Sydenham, 264, West 118th Street, Harlem, Manhattan Community Board 10, Manhattan, New York County, New York, 10026, United States
NEW YORK, NY 100261620
Phone: (212) 932-6500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-04-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220412002826 | I | Obstetrics/Gynecology | NY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92354)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NY | |
| Orthopedic Surgery | NY | |
| Physician Assistant | NY | |
| Physician Assistant | NY | |
| - | NY | |
| - | NY | |
| P A T H O L O G Y | NY | |
| Diagnostic Radiology | NY | |
| P O D I A T R Y | NY | |
| Nurse Practitioner | NY |
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