Active NPI
Jeremy M Shefner, M.D.
- Neurology Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 49535
- Practice address
- 240 W Thomas Rd # 400
Phoenix, AZ 85013 - Phone
- (602) 406-6262
- Fax
- (602) 406-6261
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 204580 | NY | |
| Clinical Neurophysiology Physician | 2084N0600X | 204580 | NY | |
| Neurology Physician | 2084N0400X | 49535 | AZ | Primary |
Addresses
Primary practice location
240 W Thomas Rd # 400
Phoenix, AZ 85013
Mailing address
240 W Thomas Rd # 400
Phoenix, AZ 85013-4407
Phone (602) 406-6262
Other practice location 1
90 Presidential Plz
4th Floor
Syracuse, NY 13202-2240
Phone (315) 464-4243
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01713868 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204580 | NY | MD | Clinical Neurophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph'S Hospital and Medical Center | Current | Accepting new patients | |
| Sjhmc Physician Services | Current | Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current | Accepting new patients | |
| St. Joseph'S Outpatient Surgery Center, LLC | Current | Accepting new patients | |
| St Josephs Pathology | Current | Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
Locations
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
500 W Thomas Rd
Ste 300A
Phoenix, AZ 85013
240 W Thomas Rd
#400
Phoenix, AZ 85013
Phone (602) 406-6262
240 W Thomas Rd
Ste 401
Phoenix, AZ 85013
Phone (602) 406-6262
500 W Thomas Rd
#300
Phoenix, AZ 85013
Phone (602) 279-7300
240 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-6262
500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
2910 N 3rd Ave
Ste 470
Phoenix, AZ 85013
Phone (602) 406-6262
File 56765
Los Angeles, CA 90074
Organizations & group practices 7
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.
-
- Critical Access Hospital Clinic/Center
- Peridot, AZ
- NPI 1265813075
TX
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
- Clinic/Center
- Bylas, AZ
- NPI 1417330713
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1265407738
-
- Emergency Care Clinic/Center
- Phoenix, AZ
- NPI 1255382412
-
- Ambulatory Surgical Clinic/Center
- Phoenix, AZ
- NPI 1306843222
-
- General Acute Care Hospital
- Redding, CA
- NPI 1477671535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1184682882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 W THOMAS RD # 400",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134407",
"telephone_number": "602-406-6262",
"fax_number": "602-406-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 W THOMAS RD # 400",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85013",
"telephone_number": "602-406-6262",
"fax_number": "602-406-6261"
}
],
"practiceLocations": [
{
"address_1": "90 Presidential Plz",
"address_2": "4th Floor",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "NY",
"postal_code": "132022240",
"country_code": "US",
"telephone_number": "315-464-4243",
"fax_number": "315-464-5350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEFNER",
"first_name": "JEREMY",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "204580",
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "NY",
"license": "204580",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "AZ",
"license": "49535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01713868",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.