NPIMap

Individual provider Active NPI

Shirley C F Noronha, MD

  • Internal Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1467566141
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43800 Issued in AZ
Practice address
2082 Mesquite Ave
Suite 106
Lake Havasu City, AZ 86403-6710
Phone
(928) 680-4233
Fax
(928) 680-6522
NPI assigned
Aug 18, 2006
Last updated
Feb 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43800 AZ Primary

Addresses

Primary practice location

2082 Mesquite Ave
Suite 106
Lake Havasu City, AZ 86403-6710

Mailing address

PO Box 147
Lake Havasu City, AZ 86405-0147
Phone (928) 680-4233

Other identifiers 2

IdentifierTypeStateIssuer
Z143367OtherAZMEDICARE GROUP PTAN
Z143368OtherAZMEDICARE INDIVIDUAL PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007000919 AZ Practitioner - Internal MedicinePractitioner - Geriatric Psychiatry 2668467325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2082 Mesquite Ave
Suite 106
Lake Havasu City, AZ 86403-6710
Phone (928) 680-4233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shirley Noronha MD LLC Internal Medicine CurrentSince Jan 2, 2011 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2082 Mesquite Ave
Ste 106
Lk Havasu Cty, AZ 86403

Interoperability endpoints

  • Direct secure messaging: shirley.noronha@cfh.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beacon of Hope HospiceLake Havasu City, AZ, CCN 031607 Hospice Contracted Managing Employee Jun 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1467566141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864050147",
            "telephone_number": "928-680-4233",
            "fax_number": "928-680-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2082 MESQUITE AVE",
            "address_2": "SUITE 106",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036710",
            "telephone_number": "928-680-4233",
            "fax_number": "928-680-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORONHA",
        "first_name": "SHIRLEY",
        "middle_name": "C F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "43800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "Z143367",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "Z143368",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.