Active NPI
Ikue Shimizu, M.D.
- MOHS-Micrographic Surgery Physician
- Houston, TX
National Provider Identifier
1194927368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- P2365
- Practice address
- 1504 Taub Loop
Houston, TX 77030-1608 - Phone
- (713) 873-8890
- NPI assigned
- Jun 1, 2007
- 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 |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | P2365 | TX | Primary |
Addresses
Primary practice location
1504 Taub Loop
Houston, TX 77030-1608
Mailing address
1977 Butler Blvd # E6.200
Houston, TX 77030-4101
Other practice location 1
2002 Holcombe Blvd
Houston, TX 77030-4211
Phone (713) 791-1414
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ishimizu16410@bcm.ghhdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Past | Accepting new patients |
Interoperability endpoints
- ikue.shimizu@direct.myteamcare.com
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Lubbock, TX
- NPI 1306894175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1194927368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1977 BUTLER BLVD # E6.200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 TAUB LOOP",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770301608",
"telephone_number": "713-873-8890"
}
],
"practiceLocations": [
{
"address_1": "2002 Holcombe Blvd",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770304211",
"country_code": "US",
"telephone_number": "713-791-1414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIMIZU",
"first_name": "IKUE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-01",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "TX",
"license": "P2365",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ishimizu16410@bcm.ghhdirect.net",
"affiliation": "N",
"address_1": "1977 Butler Blvd Ste E6",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770304101",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.