Active NPI
Michelle Kristina Shuff, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1114242799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A121201
- Practice address
- 12560 W Washington Blvd
Los Angeles, CA 90066 - Phone
- (323) 813-6218
- Fax
- (888) 308-0861
- NPI assigned
- Apr 7, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A121201 | CA | Primary |
Addresses
Primary practice location
12560 W Washington Blvd
Los Angeles, CA 90066
Mailing address
12560 W Washington Blvd
Los Angeles, CA 90066
Phone (323) 813-6218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 27, 2020 through Feb 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A121201 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1114242799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12560 W WASHINGTON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90066",
"telephone_number": "323-813-6218",
"fax_number": "888-308-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12560 W WASHINGTON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90066",
"telephone_number": "323-813-6218",
"fax_number": "888-308-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUFF",
"first_name": "MICHELLE",
"middle_name": "KRISTINA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-07",
"last_updated": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A121201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.