NPIMap

Individual provider Active NPI

Dorian G Shimotani, DO

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1407344393
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2021030411 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5772
NPI assigned
Apr 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021030411 MO
Hospitalist Physician 208M00000X 036171772 IL
Hospitalist Physician 208M00000X 2021030411 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Other practice location 1

1250 E Marshall St
Richmond, VA 23298-5051
Phone (804) 828-9726

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210914001756 MO Practitioner - Internal MedicinePractitioner - Hospitalist 5496001042 Reassigns benefits to 8 organizations
I20250408002827 IL Practitioner - Internal Medicine 5496001042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036171772ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jan 5, 2025 Accepting new patients
Mercy Hospitals East Communities CurrentSince Feb 1, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Feb 1, 2022 Accepting new patients
Fairview Heights Medical Group SC Current Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Physician Groups LC CurrentSince Aug 1, 2023 Accepting new patients
Physician Groups LC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC Hospitalist CurrentSince Feb 1, 2022 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. Hospitalist CurrentSince Feb 1, 2022 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 12

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 7

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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1407344393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-9726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMOTANI",
        "first_name": "DORIAN",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021030411",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036171772",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2021030411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.