ERIC GORGON SHAW (NPI# 1821058207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821058207 |
| Entity Type | Individual |
| Full Name | ERIC GORGON SHAW |
| Credential | M.D. |
| Practice Address |
4900 Broad Rd Syracuse NY 13215-2265 |
| Mailing Address |
20830 Cagwin Rd Watertown NY 13601-5364 |
| Practice Telephone | 3154925535 |
| Practice Fax Number | 3154928690 |
| Mailing Telephone | 3155835304 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2013-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 224829 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02650246 | 05 | |
| NY | RAILROAD MEDICARE | P00869153 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912557927 | Eric Shaw | Behavior Technician | 2521 N Elms Rd, Flushing, MI 48433-9423 | 2019-09-12 |
| 1336569250 | Eric Shaw | Student in an Organized Health Care Education/Training Program | 1430 Tulane Ave, Sl-42, New Orleans, LA 70112-2632 | 2014-04-17 |
| 1396908711 | Eric T Shaw | Pediatrics | 13402 W Coal Mine Ave, Suite 200, Littleton, CO 80127-5407 | 2008-07-07 |
| Street Address |
4900 BROAD RD |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13215-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336143221 | David C Canfield | Anesthesiology | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2005-06-08 |
| 1205474335 | Meaghan Porter | Physical Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-12-19 |
| 1982262655 | Ryan Christopher Staib | Nurse Anesthetist, Certified Registered | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-05-29 |
| 1164989505 | Jessica Detor | Social Worker | 4900 Broad Rd, Physician Office Building North 3n, Syracuse, NY 13215-2265 | 2019-02-21 |
| 1316402415 | Oleksandr Kaplun | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-02-04 |
| 1003390204 | Ianna Javier Garcia | Occupational Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-24 |
| 1194207241 | Rebekah Schu | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-05 |
| 1669990065 | Katrina E Garrigan | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-06 |
| 1336667948 | Kristy Mcgough | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-04 |
| 1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367785 | Jeffrey Alan Gaulrapp | Registered Nurse | Upstate University Hospital Community General Campus, 4900 Broad Road, Syracuse, NY 13215 | 2020-05-08 |
| 1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
| 1083004907 | Roger G Levine Md | Psychiatric Residential Treatment Facility | 4914 West Seneca Turnpkie, Syracuse, NY 13215 | 2015-01-30 |
| 1558771071 | Edleanna Robinson | Licensed Practical Nurse | 5075 W Seneca Turnpike, Syracuse, NY 13215 | 2014-05-06 |
| 1689013450 | Rhonda Lee Philopena | Emergency Medicine | 4900 Broad Rd 1st Fl, Syracuse, NY 13215 | 2013-06-14 |
| 1962778498 | Marie Anne Stevens | Licensed Practical Nurse | 4057 Seneca Tpk, Van Duyn Home and Hospital, Syracuse, NY 13215 | 2012-03-29 |
| 1033439088 | Anna-marie Simpson | Chiropractor | 4922 W Seneca Tpke, Syracuse, NY 13215 | 2010-06-01 |
| 1992028690 | A John Wylie | Pharmacist | 4840 Sherwood Dr., Syracuse, NY 13215 | 2010-03-09 |
| 1669616512 | Asalim A Thabet | Emergency Medicine | 4900 Braod Rd, 1st Fl, Syracuse, NY 13215 | 2009-04-22 |
| 1992948707 | Jesse Reed Gutnick | Surgery | 4900 Borad Rd, Suite 23 North, Syracuse, NY 13215 | 2009-04-08 |
| Find all providers in zip 13215 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316367394 | Keith Schenker | Emergency Medicine | 750 Adams Street, Syracuse, NY 13210 | 2014-04-17 |
| 1417391301 | Lindsey Pryor | Emergency Medicine | 750 E Adams St # Uh-1814, Syracuse, NY 13210-2342 | 2013-04-22 |
| 1811925043 | Francine D Cantor | Emergency Medicine | 515 Sedgwick Dr, Syracuse, NY 13203-1132 | 2006-06-28 |
| 1427010487 | Ruth H Hart | Emergency Medicine | 217 S Salina St, Syracuse, NY 13202-1501 | 2006-04-05 |
| 1336644400 | Vlad Panaitescu | Emergency Medicine | 766 Irving Ave, Syracuse, NY 13210-1630 | 2018-03-29 |
| 1508386020 | Phillip Mackewicz | Emergency Medicine | 750 E Adams St, Syracuse, NY 13210-2306 | 2017-06-26 |
| 1205363488 | Sachin Santhakumar | Emergency Medicine | 750 E Adams St, Syracuse, NY 13210-2306 | 2017-05-18 |
| 1154856862 | Casey Nilsen Moore | Emergency Medicine | 750 E Adams St, Syracuse, NY 13210-2306 | 2017-05-01 |
| 1265966600 | James Yaroslav Yarovoy | Emergency Medicine | 750 E Adams St, Syracuse, NY 13210 | 2017-04-12 |
| 1003348582 | Bethany A Hawke | Emergency Medicine | 750 E Adams St, Syracuse, NY 13210-2306 | 2017-04-03 |
| Find all providers in SYRACUSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.