Mark S Shulman, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G36884 Issued in CA

Practice address

1414 Manera Ventosa
San Clemente, CA 92673-3663

Phone

(413) 813-9539

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Caritas Medical Group, Inc.

  • Specialist
  • Brighton, MA
  • NPI 1174513204
  NPD (past)
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1275520371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 MANERA VENTOSA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733663",
            "telephone_number": "413-813-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MANERA VENTOSA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733663",
            "telephone_number": "413-813-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G36884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3043118",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shore Light Behavioral Health LLC
• Shorecliffs Medical Group Inc
• Shreya Health of California
• Shreya Health of California, Inc.
• Lisa Shue, MD
• Eric Sickinger, D.O.
• Gregory Todd Siebert, DC
• Signature Endodontics
• Signature Physical Therapy P C
• Angela Sigua

• Anesthesiology Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.