Active NPI
Michael James Shaffran, LCSW
- Clinical Social Worker
- Morro Bay, CA
National Provider Identifier
1053461277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 15788
- Practice address
- 159 Luzon St
Morro Bay, CA 93442-3019 - Phone
- (805) 225-1131
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 15788 | CA | Primary |
Addresses
Primary practice location
159 Luzon St
Morro Bay, CA 93442-3019
Mailing address
159 Luzon St
Morro Bay, CA 93442-3019
Phone (805) 225-1131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS 15788 | Other | CA | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101004000615 | CA | Practitioner - Clinical Social Worker | 1355533837 | Practice locations: Templeton, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
160 Hawley St
Templeton, CA 93465-5448
Phone (805) 296-3456
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 15788 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1053461277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 LUZON ST",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934423019",
"telephone_number": "805-225-1131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 LUZON ST",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934423019",
"telephone_number": "805-225-1131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFRAN",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 15788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "LCS 15788",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Morro Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.