Individual provider Active NPI

David Alexander Shustik, M.D.

  • Surgery Physician
  • San Francisco, CA
National Provider Identifier
1053442384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
NOT LICENSED Issued in CA
Practice address
925 Irving St
Apartment #304
San Francisco, CA 94122-2225
Phone
(415) 681-8223
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NOT LICENSED CA Primary

Addresses

Primary practice location

925 Irving St
Apartment #304
San Francisco, CA 94122-2225

Mailing address

925 Irving St
Apartment #304
San Francisco, CA 94122-2225
Phone (415) 681-8223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NOT LICENSEDCAMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053442384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 IRVING ST",
            "address_2": "APARTMENT #304",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222225",
            "telephone_number": "415-681-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 IRVING ST",
            "address_2": "APARTMENT #304",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222225",
            "telephone_number": "415-681-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTIK",
        "first_name": "DAVID",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "NOT LICENSED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.