Individual provider Active NPI

Dorothy A Shoup, M.D.

  • Obstetrics Physician
  • Redwood City, CA
National Provider Identifier
1205885662
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
G64767 Issued in CA
Practice address
2900 Whipple Ave
#135
Redwood City, CA 94062-2843
Phone
(650) 366-5594
Fax
(650) 366-6352
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G647670 CA
Obstetrics Physician 207VX0000X G64767 CA Primary

Addresses

Primary practice location

2900 Whipple Ave
#135
Redwood City, CA 94062-2843

Mailing address

2900 Whipple Ave
#135
Redwood City, CA 94062-2843
Phone (650) 366-5594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20060504001010 CA Practitioner - Obstetrics/Gynecology 5092726083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LPCH Medical Group Div of LucileGroup PAC ID 0840298543, 332 clinicians

Practice addresses (Care Compare)

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 498-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G647670CAMDSpecialist
G64767CAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Jun 1, 2016 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

2900 Whipple Ave
Ste 135
Redwood City, CA 94062
Phone (650) 366-5594

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1205885662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 WHIPPLE AVE",
            "address_2": "#135",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622843",
            "telephone_number": "650-366-5594",
            "fax_number": "650-366-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WHIPPLE AVE",
            "address_2": "#135",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622843",
            "telephone_number": "650-366-5594",
            "fax_number": "650-366-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "DOROTHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G647670",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "G64767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.