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Active NPI 1962093674 Individual Practitioner Male Practitioner

Stag Blair Shadduck

Physician Assistant • Edgewood, KY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Stag Shadduck is a certified Physician Assistant practicing in Edgewood, KY. With approximately 5 years of clinical experience since completing medical education in 2021, Stag Shadduck delivers high-quality medical care to the local community at 560 S LOOP RD.

Stag Shadduck is affiliated with Orthocincy Orthopaedics And Sports Medicine Psc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, treatment of broken neck of thigh bone with bone implant, x-ray of ankle, minimum of 3 views. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

560 S Loop Rd

Edgewood, KY 410173405

Telephone 8593012663
Fax 8598177848
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Edgewood, KY

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -2.6 yrs vs City Avg
City Avg: 7.6 Yrs
State Avg: 12.7 Yrs
Regional Practice Density
51 Specialists

Practicing in Edgewood, KY (1973 Statewide)

Telehealth Adoption Rate
11.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
72.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shadduck (5 Years) 5 Yrs
Edgewood Specialty Average (7.6 Years) 7.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
52 51 $155.00 $71.11
27245 Treatment of broken neck of thigh bone with bone implant
40 38 $890.00 $158.38
73610 X-ray of ankle, minimum of 3 views
36 27 $84.97 $25.14
73630 X-ray of foot, minimum of 3 views
25 18 $91.40 $25.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
23 23 $185.00 $103.12
73552 X-ray of thigh bone, minimum 2 views
19 17 $96.16 $24.24
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement
13 13 $561.00 $154.12

Medical Specialties & State Licenses

CMS Verified: 2021-08-18
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License KY TC072

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Orthocincy Orthopaedics And Sports Medicine Psc

560 S Loop Rd, Edgewood, KY 410173405

Phone: 8593012663

Orthocincy Orthopaedics And Sports Medicine Psc

560 S Loop Rd, Edgewood, KY 410173405

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Dorian Wood , MD

Orthopaedic Surgery

NPI 1003260753

Doctor of Medicine (M.D.)

Dr. Matthew Stevens , DPT

Physical Therapist

NPI 1003359043

Doctor of Physical Therapy

Allen Kramer

Nurse Practitioner - Family

NPI 1013505395
NPI 1023010279

Doctor of Podiatric Medicine

Spencer Cole , MPAS, PA-C

Physician Assistant

NPI 1023365715

MPAS, Physician Assistant (Certified)

Dr. John Linz , MD

Orthopaedic Surgery - Foot and Ankle Surgery

NPI 1053316315

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 18, 2021

Registered at 560 S LOOP RD, EDGEWOOD, KY 410173405 (Tel: 8593012663)

📍
Updated Business Mailing Address August 18, 2021

Registered at 560 S LOOP RD, EDGEWOOD, KY 410173405 (Tel: 8593012663)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 18, 2021

Physician Assistant (License #TC072 in KY)

NPI Profile Active January 27, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location January 27, 2021

Registered at 35 WOLF LN APT 3, ATHENS, PA 188109322 (Tel: 6078572758)

📍
Updated Business Mailing Address January 27, 2021

Registered at 35 WOLF LN APT 3, ATHENS, PA 188109322 (Tel: 6078572758)

👤
Provider Name / Credentials Updated January 27, 2021

Recorded as STAG SHADDUCK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 27, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration January 27, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1962093674
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 27, 2021
Last Update: August 18, 2021
Sole Proprietor: Yes

Mailing Address

560 S Loop Rd

Edgewood, KY 410173405

Phone: 8593012663

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.