NPIMap

Individual provider Active NPI

William Michael Shimanek, MD

  • Neurology Physician
  • Portland, OR
National Provider Identifier
1053873067
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD215091 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-8211
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD215091 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230824003906 OR Practitioner - Neurology 7618206137 Reassigns benefits to 1 organization
I20250818001500 WA Practitioner - Neurology 7618206137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

501 N Graham St
Suite 445
Portland, OR 97227-2002
Phone (503) 944-6300

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD215091ORMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Jun 16, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Jun 16, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Jun 16, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jun 16, 2025 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

501 N Graham St
Ste 445
Portland, OR 97227
Phone (503) 284-5220

1040 NW 22nd Ave
Ste 420
Portland, OR 97210
Phone (503) 229-7566

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2121 NE 139th St
Ste 205
Vancouver, WA 98686
Phone (360) 487-4707

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1053873067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMANEK",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD215091",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.