Individual provider Active NPI

Steven Shimoyama, M.D.

  • Orthopaedic Surgery Physician
  • Marina del Rey, CA
National Provider Identifier
1386663615
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G47794 Issued in CA
Practice address
4644 Lincoln Blvd
Suite 414
Marina del Rey, CA 90292-6313
Phone
(310) 821-5723
Fax
(310) 821-5828
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G47794 CA Primary

Addresses

Primary practice location

4644 Lincoln Blvd
Suite 414
Marina del Rey, CA 90292-6313

Mailing address

4644 Lincoln Blvd
Suite 414
Marina del Rey, CA 90292-6313
Phone (310) 821-5723

Other identifiers 2

IdentifierTypeStateIssuer
954233875MedicaidCA
954233875OtherCAEMPLOYER TAX ID

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
I20080119000149 CA Practitioner - Orthopedic Surgery 8527149236 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Southern California Keck School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8540 S Sepulveda Blvd
Suite 1111
Los Angeles, CA 90045-3819
Phone (424) 331-5112

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark W Tamarin MD Inc Past Accepting new patients
Navid Hakimian MD a Professional Corporation Past Accepting new patients
Daniel Marcus MD Inc PastSince Jul 14, 2014 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1386663615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 414",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-821-5723",
            "fax_number": "310-821-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 414",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-821-5723",
            "fax_number": "310-821-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMOYAMA",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G47794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954233875",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER TAX ID",
            "identifier": "954233875",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.