MR. SAMUEL TEAGAN SHAW (FNP-C) – Family Nurse Practitioner, NPI 1073248787
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,798 NURSE PRACTITIONER in ID
Provider Addresses for MR. SAMUEL TEAGAN SHAW (FNP-C)
1835 HARRISON ST N UNIT 16104
TWIN FALLS, ID 833014294
Phone: (208) 431-3570
Type: Mailing
1039 Blake St N
Twin Falls, ID 833013108
Phone: (208) 431-3570
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: 2022-11-14
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 |
|---|---|---|---|---|
| I20221114000993 | I | Nurse Practitioner | ID | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 35 | 35 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 19 | 19 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 83301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | WA | |
| Interventional Radiology, Diagnostic Radiology, Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | GA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | OR |
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