Gary A Shintani, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101013542 Issued in MI

Practice address

400 Hobart St
Cadillac, MI 49601-2331

Phone

(231) 876-7200

Fax

(231) 876-6830

NPI assigned

Aug 1, 2005

Last updated

Oct 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WI, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• Sound Inpatient Physicians-Michigan, PLLC

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1093967861
  NPD
• Divine Savior Healthcare, Inc.

  dba Aspirus Portage Clinic

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD
• Indigo Services, PLC

  • Hospitalist Physician
  • Traverse City, MI
  • NPI 1790769669

  Internal Medicine

  NPD (past)
• Physician Practice Network

  dba Cadillac Hospitalist

  • Internal Medicine Physician
  • Cadillac, MI
  • NPI 1841223948
  NPD (past)

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1083615025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6545",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496966545",
            "telephone_number": "231-922-9270",
            "fax_number": "231-922-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOBART ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012331",
            "telephone_number": "231-876-7200",
            "fax_number": "231-876-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINTANI",
        "first_name": "GARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101013542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "4236844",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREF CHOICE BILLING NUMBE",
            "identifier": "127835",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BILLING NUMBER",
            "identifier": "110H310180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "27544",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMM CHOICE BILLING NUMBE",
            "identifier": "383552631057",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4236844",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Jarvis Seymour, DDS
• James David Shadoan, MD
• Ella Rose Shafer
• Sheri Sheese, MSW,ACSW,LMSW
• Carson Donald Shell, D.D.S.
• Jessica Shivlie
• Kiley Shoemaker
• Robin Ray Shook, ANP-BC
• Randall James Sigler
• Kimberly A. Silbor, LPC, LMHC

• Internal Medicine Physician in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.