Mitchell C Shultz, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G079168 Issued in CA

Practice address

18350 Roscoe Blvd
Suite 101
Northridge, CA 91325-4109

Phone

(818) 349-8300

Fax

(818) 349-2214

NPI assigned

Sep 14, 2006

Last updated

Apr 25, 2008By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

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 2

Specialty

Ophthalmology

Education

New York Medical College, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

65.01 of 100Reported as individual

Quality

36.01

Promoting interoperability

78

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• David M Shultz M D , Inc

  • Ophthalmology Physician
  • Northridge, CA
  • NPI 1497851497
  NPD (past)
• Dignity Community Care

  dba Northridge Hospital Medical Center

  • General Acute Care Hospital
  • Northridge, CA
  • NPI 1417089350
  NPD (past)
• Freedom Vision Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Encino, CA
  • NPI 1669414306
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1427153022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254109",
            "telephone_number": "818-349-8300",
            "fax_number": "818-349-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254109",
            "telephone_number": "818-349-8300",
            "fax_number": "818-349-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "MITCHELL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G079168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G079168",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana K Shore
• Philip S Shore, MD
• Cherie A Short, PA
• Vivian Shoukrun, MD
• Ellen Shuham, OD
• Kaili Ji Shumilak, D.O.
• Siamak Etehad MD Inc a Medical Corporation
• Siamak Etehad, MD, Inc. a Medical Corporation
• Jenny R Siaw
• Amanda Sibley, N.P.

• Ophthalmology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.