Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Olivia Madeline Shaw, MS, PA-C

Individual provider Physician Assistant · NPI 1720740665

Olivia Madeline Shaw, MS, PA-C is a Physician Assistant in Troy, Michigan. Qualified in 2022, 4 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2021
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

44201 Dequindre Rd
Troy, MI 48085-1117
Phone: (248) 964-8193
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 44199 Dequindre Rd Ste 315, Troy, MI 48085-1128 — (248) 964-3600
  • 60005 Campground Rd Ste 600, Washington, MI 48094-3447 — (586) 372-3500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011257
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5601011257 (MI)

Record details

NPI number1720740665
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , PA-C
Sole proprietorNo
NPI enumeratedOctober 7, 2021
Last updated in NPPESJanuary 12, 2024
Certification dateJanuary 12, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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