MR. RYAN T SHAW – Medical Physician Assistant, NPI 1568146249

MR. RYAN T SHAW is a healthcare provider. based in Springfield, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA101760 (MA). The NPI Number for MR. RYAN T SHAW is 1568146249

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
MR. RYAN T SHAW
NPI
1568146249
Phone
(978) 944-4023
Address
73 TULSA ST
Enumeration Date
13 June 2023
Last Update Date
25 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5089162888
Graduation Year
2025 (1 year ago)
PAC ID
9032610217
Group Practice PAC ID
9436659927
Professional Enrollment ID
I20250828004846
Address ID
MA023010000BR500XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

5,093 PHYSICIAN ASSISTANT in MA

Provider Addresses for MR. RYAN T SHAW

  • 73 TULSA ST

    SPRINGFIELD, MA 011182242

    Phone: (978) 944-4023

    Type: Mailing

  • 588 LONGMEADOW ST

    LONGMEADOW, MA 011062212

    Phone: (978) 944-4023

    Type: Location

  • 500 WESTGATE DR STE 10

    BROCKTON, MA 023011855

    Phone: (978) 944-4023

    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: 2025-08-28

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
I20250828004846IPhysician AssistantMATBD

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 01118)

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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: 9436659927View full group profile
NameSpecialtyState
Physician AssistantMA
Internal MedicineMA
Physician AssistantMA

Reviews

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Frequently asked questions

What is the registry number for MR. RYAN T SHAW?
The registry entry for MR. RYAN T SHAW shows NPI 1568146249.
Does the public listing show MR. RYAN T SHAW as active?
MR. RYAN T SHAW's NPI record reflects an active status in NPPES.
What does the directory say MR. RYAN T SHAW does?
Insurance directories may phrase it differently, but here MR. RYAN T SHAW maps to Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MR. RYAN T SHAW tied to Springfield, Massachusetts?
If you are local to Springfield, Massachusetts, MR. RYAN T SHAW may be relevant to your search.
Why is information missing for MR. RYAN T SHAW?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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