Doctor profile · Federal record

Dr. Stag Shadduck

Physician Assistant · Edgewood, KY

  • NPI 1962093674
  • Accepts Medicare
  • MIPS 90.4 / 100 · 2023
  • 5 yrs in practice
  • Male
  • Solo practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
560 S Loop RD
Edgewood, KY 410173405
(859) 301-2663
fax (859) 817-7848

Credentials & registration

NPPES · NUCC
NPI registered
January 2021 — 5 yrs on file
Profile last updated
August 18, 2021
Year of graduation
2021 — 5 yrs since
Specialty taxonomy
363A00000X — NUCC code
State license (1)
Kentucky #TC072

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1962093674. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
186
Distinct HCPCS
8
Medicare allowed
$17,357
HCPCS Description Services Patients Avg allowed
99214 Established patient office or other outpatient visit, 30-39 minutes 43 43 $90
27245 Treatment of broken neck of thigh bone with bone implant 36 35 $154
73610 X-ray of ankle, minimum of 3 views 27 26 $30
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement 19 18 $151
99204 New patient office or other outpatient visit, 45-59 minutes 19 19 $132
73630 X-ray of foot, minimum of 3 views 16 14 $26
99213 Established patient office or other outpatient visit, 20-29 minutes 15 13 $71
73620 X-ray of foot, 2 views 11 11 $26

In context: peer comparison

Among 8 peers in this city , average services per provider: 125. This provider delivers 1.5× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
38
Patients
35
Total drug cost
$150
Drug Type Claims Patients Total cost
Tramadol Hcl Generic 27 24 $78
Methylprednisolone Generic 11 11 $72

Frequently asked questions

Auto-generated from federal data
What is Dr. Stag Shadduck's medical specialty?
Dr. Stag Shadduck practices Physician Assistant in Edgewood, KY.
Where does Dr. Stag Shadduck practice?
Dr. Stag Shadduck practices at 560 S Loop RD, Edgewood, KY 410173405. Office phone: 8593012663.
What is Dr. Stag Shadduck's NPI?
Dr. Stag Shadduck's National Provider Identifier (NPI) is 1962093674, issued by NPPES.
Does Dr. Stag Shadduck accept Medicare assignment?
Yes. Dr. Stag Shadduck accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Stag Shadduck commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99214); Treatment of broken neck of thigh bone with bone implant (HCPCS 27245); X-ray of ankle, minimum of 3 views (HCPCS 73610). Source: CMS Medicare Physician & Other Practitioners file.