Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

William J Shaw IV, PA-C

Individual provider Physician Assistant · NPI 1134258163

William J Shaw IV, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2005, 21 years ago. Practices with Michael H Boothby, MD, PA, a 12-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
21
Licensed in
TX
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2901 Acme Brick Plz
Fort Worth, TX 76109-4124
Phone: (817) 529-1900
Fax: (817) 529-1910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA04686 (TX)

Record details

NPI number1134258163
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 5, 2007
Last updated in NPPESNovember 6, 2024
Certification dateNovember 6, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Michael H Boothby, Md, Pa — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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