Stag B. Shadduck, PA-C
NPI 1962093674ActiveIndividual· Physician Assistant· Edgewood, KY
Physician Assistant (PA-C) with Orthocincy Orthopaedics and Sports Medicine PSC, practicing in Edgewood, Kentucky. 205 Medicare patients in 2024, $25,362 paid; all of their 92 Part D prescriptions were generic. Lists St Elizabeth Florence as a hospital affiliation.
Overview
| NPI | 1962093674 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jan 27, 2021 |
| Last updated in NPPES | Oct 20, 2026 |
| Certified by provider | Oct 20, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA2904 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (KY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 205 |
|---|---|
| Services billed | 455 across 64 procedure codes |
| Paid by Medicare | $25,362 |
Part D prescriptions in 2024
| Prescriptions (claims) | 92 · 95 30-day fills |
|---|---|
| Patients | 67 |
| Total drug cost | $843.91 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Orthocincy Orthopaedics and Sports Medicine PSCEdgewood, KY · 165 clinicians
Hospital affiliation
- St Elizabeth FlorenceFlorence, KY
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 53 physician assistants in Edgewood · All physician assistants in Kentucky