Gary G Shi, MD, PHD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A92230 Issued in CA

Practice address

617 New York Ranch Rd
Jackson, CA 95642-9328

Phone

(209) 257-0292

Fax

(209) 257-0676

NPI assigned

Feb 2, 2006

Last updated

Jan 23, 2012By the provider in NPPES

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 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

Specialty

Hematology/OncologyAlso: Hematology, Internal Medicine, Medical Oncology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary G Shi MD Inc

  dba Northern California Cancer Specialists

  • Hematology & Oncology Physician
  • Jackson, CA
  • NPI 1619063435
  Medicare reassignment NPD Authorized official

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

• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Roseville Medical Center

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Amador Hospital

  • General Acute Care Hospital
  • Jackson, CA
  • NPI 1447494323
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1235101437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0292",
            "fax_number": "209-257-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0292",
            "fax_number": "209-257-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "GARY",
        "middle_name": "G",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A92230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A92230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ekaterina D Seeba, FNP
• Natalie Diane Serrano, RN
• Shanti Siddiqui, M.D. a Professional Corporation
• Kathryn Sharp, MS, PPS
• Julia Ann Shelby, NP
• Jennifer Monique Shoemaker, MD
• Anisa Shoghi Ghaleh Shahi, PHARMD
• Mohammed Nasiruddin Siddiqui, MD FACS
• Shanti Siddiqui, M.D.
• Kevin Sidhu, DO

• Hematology & Oncology Physician in Jackson, CA
• Providers in Jackson, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.