MR. BENJAMIN ALLEN SHAW (L.I.S.W.) – Clinical Social Worker, NPI 1124400510

MR. BENJAMIN ALLEN SHAW (L.I.S.W.) is a healthcare provider. based in Dubuque, Iowa. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials L.I.S.W.. They hold a License No. 007817 (IA). The NPI Number for MR. BENJAMIN ALLEN SHAW (L.I.S.W.) is 1124400510

Main info

Male
15 Years Of Experience
Name
MR. BENJAMIN ALLEN SHAW (L.I.S.W.)
NPI
1124400510
Phone
(563) 690-2850
Address
1690 ELM ST STE 300
Enumeration Date
23 June 2015
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2011 (15 years ago)
PAC ID
6305264581
Group Practice PAC ID
0345343158
Professional Enrollment ID
I20200921001662
Address ID
IA520013679Du1690XSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

827 CLINICAL SOCIAL WORKER in IA

Provider Addresses for MR. BENJAMIN ALLEN SHAW (L.I.S.W.)

  • 1690 ELM ST STE 300

    DUBUQUE, IA 520013679

    Phone: (563) 690-2850

    Fax: (563) 557-8488

    Type: Location

  • 2255 JFK RD

    DUBUQUE, IA 520022846

    Phone: (563) 582-0044

    Type: Mailing

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: 2020-09-21

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200921001662IClinical Social WorkerIATBD

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.

Verify on CMS Revalidation Lookup Tool

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 52001)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345343158View full group profile
NameSpecialtyState
P S Y C H I A T R YWY
Nurse PractitionerIA
-IA
Nurse PractitionerWI
Nurse PractitionerIA
P S Y C H I A T R YIL
Internal MedicineIA
O B S T E T R I C S/ G Y N E C O L O G YIA
Nurse PractitionerIA
-IA

Reviews

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Frequently asked questions

What is MR. BENJAMIN ALLEN SHAW (L.I.S.W.)'s NPI number?
MR. BENJAMIN ALLEN SHAW (L.I.S.W.)'s NPI is 1124400510 — the number used across U.S. healthcare to identify this provider.
Is MR. BENJAMIN ALLEN SHAW (L.I.S.W.) still an active registrant?
MR. BENJAMIN ALLEN SHAW (L.I.S.W.) carries an active NPI according to the public dataset.
How would a patient describe MR. BENJAMIN ALLEN SHAW (L.I.S.W.)'s focus?
For MR. BENJAMIN ALLEN SHAW (L.I.S.W.), the primary taxonomy reads as Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Iowa is MR. BENJAMIN ALLEN SHAW (L.I.S.W.) registered?
Use Dubuque, Iowa as the headline location for MR. BENJAMIN ALLEN SHAW (L.I.S.W.) here.
Can I trust this NPI listing for MR. BENJAMIN ALLEN SHAW (L.I.S.W.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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