Lonny J Shavelson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G37055 Issued in CA

Practice address

1030 International Blvd
Oakland, CA 94606-3730

Phone

(510) 238-5400

Fax

(510) 238-5437

NPI assigned

May 5, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Oakland, CA
  • NPI 1508874454
  NPD (past)
• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Berkeley, CA
  • NPI 1780692632
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1407804974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063730",
            "telephone_number": "510-238-5400",
            "fax_number": "510-238-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063730",
            "telephone_number": "510-238-5400",
            "fax_number": "510-238-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVELSON",
        "first_name": "LONNY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G37055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G370550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anjali Shastri
• Kaiayo Z Shatteen
• Julia Shaub
• Megan Shaughnessy-Mogill
• Jennifer Shaul, OTR/L
• Raven Mariah Shavers, MHRS
• Tabari Shavers, CMT
• Rachel Shaw-Krauss
• Annette Shaw, SUD COUNSELOR LL
• Breckney Shaw

• Emergency Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.