Dmitriy Shnayderman, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

A167361 Issued in CA

Practice address

250 Cherry LN Ste 116
Manteca, CA 95337-4398

Phone

(209) 647-2184

Fax

(414) 259-9290

NPI assigned

May 28, 2013

Last updated

Apr 19, 2022By the provider in NPPES

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

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

Diagnostic Radiology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Desert Radiology Medical Group IncGroup PAC ID 0749173789, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score

84.08 of 100Reported as group

Quality

81.28

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Palm Desert Radiology Medical Group, Inc

  dba Eisenhower Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1124079868
  Medicare reassignment Care Compare group NPD
• Coast Radiology Imaging and Intervention Inc

  • Diagnostic Radiology Physician
  • Mission Viejo, CA
  • NPI 1376690636
  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• County of Santa Clara

  dba SCVMC Physician Services

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  Medicare reassignment NPD
• County of Santa Clara

  dba Valley Health Center Alexian

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  dba Josefina Narvaez Mental Health Center MH Aoa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• County of Santa Clara

  dba Valley Health Center Lundy

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  dba Valley Health Center Sunnyvale

  • Federally Qualified Health Center (FQHC)
  • Sunnyvale, CA
  • NPI 1336326974
  NPD
• County of Santa Clara

  dba SCVMC Outpatient Pharmacy

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• Delta Sierra Medical Group, Inc

  • Cardiovascular Disease Physician
  • French Camp, CA
  • NPI 1578598595
  NPD (past)

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

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1346687670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHERRY LN STE 116",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374398",
            "telephone_number": "209-647-2184",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHERRY LN STE 116",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374398",
            "telephone_number": "209-647-2184",
            "fax_number": "414-259-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHNAYDERMAN",
        "first_name": "DMITRIY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-28",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A167361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shield Care Home
• Yong L Shih, D.O
• Brian Taelor Shin
• Michelle Shipley, PHARM D
• Macee Kaelynn Shirley
• Puja Shrestha, DDS
• Kirinpreet Sibia
• Amir Ahmed Siddiqui
• Anupender Singh Sidhu, M.D.
• Gurpreet Kaur Sidhu

• Vascular & Interventional Radiology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.