Stag Shadduck
NPI 1962093674 · Physician Assistant · Edgewood, KY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Stag Shadduck is a Physician Assistant provider in Edgewood, KY (NPI 1962093674).
Provider details
- NPI number
- 1962093674
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- TC072 (KY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
5 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
208 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 52 | $71 |
| Treatment of Broken Neck of Thigh Bone With Bone Implant27245 | 40 | $158 |
| X-Ray of Ankle, Minimum of 3 Views73610 | 36 | $25 |
| X-Ray of Foot, Minimum of 3 Views73630 | 25 | $26 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 23 | $103 |
| X-Ray of Thigh Bone, Minimum 2 Views73552 | 19 | $24 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 3 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Methylprednisolone | 19 | 19 |
| Diclofenac Sodium | 15 | 13 |
| Cephalexin | 11 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-01-27
- Last updated
- 2021-08-18
- Certified
- 2021-08-18
Frequently asked questions
- What is Stag Shadduck's NPI number?
- Stag Shadduck's National Provider Identifier (NPI) is 1962093674, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Stag Shadduck's specialty?
- Stag Shadduck is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Stag Shadduck located?
- Stag Shadduck's practice location on file with NPPES is 560 S Loop Rd, Edgewood, KY 41017-3405.
- What is Stag Shadduck's phone number?
- The practice phone number listed in the NPPES registry for Stag Shadduck is (859) 301-2663.
- Does Stag Shadduck accept Medicare?
- Stag Shadduck is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Stag Shadduck's NPI active?
- Yes — Stag Shadduck's NPI (1962093674) is active in the NPPES registry as of the last update on 2021-08-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.