Individual provider Active NPI

Elaine Carole Shoji, M.D.

  • Pediatrics Physician
  • Rolling Hills Estates, CA
National Provider Identifier
1538265160
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G35402 Issued in CA
Practice address
827 Deep Valley Dr
Suite 102
Rolling Hills Estates, CA 90274-3647
Phone
(310) 541-8801
Fax
(310) 541-8703
NPI assigned
Sep 14, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G35402 CA Primary

Addresses

Primary practice location

827 Deep Valley Dr
Suite 102
Rolling Hills Estates, CA 90274-3647

Mailing address

827 Deep Valley Dr
Suite 102
Rolling Hills Estates, CA 90274-3647
Phone (310) 541-8801

Other identifiers 2

IdentifierTypeStateIssuer
33-0277966OtherCAFEDERAL TAX I.D.
G35402OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G35402CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Group Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: eshoji257282@oc.providencedirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1538265160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 DEEP VALLEY DR",
            "address_2": "SUITE 102",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743647",
            "telephone_number": "310-541-8801",
            "fax_number": "310-541-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 DEEP VALLEY DR",
            "address_2": "SUITE 102",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743647",
            "telephone_number": "310-541-8801",
            "fax_number": "310-541-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOJI",
        "first_name": "ELAINE",
        "middle_name": "CAROLE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G35402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX  I.D.",
            "identifier": "33-0277966",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G35402",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.