John Michael Shutack, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

0101102740 Issued in VA

Practice address

300 Medical Pkwy Ste 206
Chesapeake, VA 23320

Phone

(757) 690-8990

Fax

(757) 198-6944

NPI assigned

Sep 26, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Merit-based Incentive Payment System (MIPS)

Final score

90.57 of 100Reported as group

Quality

87.01

Promoting interoperability

100

Improvement activities

40

Cost

81.57

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Atlantic Neurosurgery PC

  • Neurological Surgery Physician
  • Virginia Beach, VA
  • NPI 1477935682
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1104927458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-842-4481",
            "fax_number": "757-312-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY STE 206",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-690-8990",
            "fax_number": "757-198-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTACK",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101102740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "0101102740",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Namratha Shripad, MD
• Ryan Clark Shuck, DDS
• Laura Kathleen Shuey, BCBA
• Haley Shultz
• Lyubov B Shur-Allen, MD
• Sukhdeep Sidhu
• Fred Harris Siegel, M.D.
• Justin Siegel, MD
• Lewis H Siegel, M.D.
• Signature Nursing at Home

• Neurological Surgery Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Neurological Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.

Verify at the official NPI Registry.