SHANE J DEGEN M.D. NPI 1336127240

NPI Information

  • NPI: 1336127240
  • Provider Name: SHANE J DEGEN, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1630 COMMANCHE AVE
    GREEN BAY, WI
    ZIP 54313
  • Phone: (920) 430-4700

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NPI Details

Shane J Degen, M.D. is a family medicine in Green Bay, WI with 21 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Shane J Degen, M.D. NPI is 1336127240. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:2004

The provider's business location address is:

1630 COMMANCHE AVE
GREEN BAY, WI
ZIP 54313-089
Phone: (920) 430-4700

The NPI 1336127240 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Blood test, clotting time (HCPCS:85610)
  • Blood test, comprehensive group of blood chemicals (HCPCS:80053)
  • Blood test, basic group of blood chemicals (calcium, total) (HCPCS:80048)
  • Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
  • Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
  • Hemoglobin a1c level (HCPCS:83036)
  • Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85027)
  • Blood test, thyroid stimulating hormone (tsh) (HCPCS:84443)
  • Manual urinalysis test with examination using microscope, automated (HCPCS:81001)
  • Urine microalbumin (protein) level (HCPCS:82043)
  • Creatinine level to test for kidney function or muscle injury (HCPCS:82570)

The enumeration date for this NPI number is 1/3/2006 and was last updated on 10/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine47641MINNESOTANo
2207Q00000XFamily Medicine50647 - 020WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1080014432MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
2075100113MEDICARE OSCAR/CERTIFICATIONWISCONSIN
3I40467MEDICARE UPIN
4073100056MEDICARE OSCAR/CERTIFICATIONWISCONSIN
5241127000MEDICAIDMINNESOTA
6073050057MEDICARE OSCAR/CERTIFICATIONWISCONSIN
7071700060MEDICARE OSCAR/CERTIFICATIONWISCONSIN
8002150263MEDICARE OSCAR/CERTIFICATIONWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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