Individual provider Active NPI

Mark Clifford Schultz, M.D.

  • Neurology Physician
  • Valencia, CA
National Provider Identifier
1568411189
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G45233 Issued in CA
Practice address
23823 Valencia Blvd Ste 115
Valencia, CA 91355-9509
Phone
(661) 255-5444
Fax
(661) 255-8447
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X G45233 CA
Neurology Physician 2084N0400X G45233 CA Primary

Addresses

Primary practice location

23823 Valencia Blvd Ste 115
Valencia, CA 91355-9509

Mailing address

23823 Valencia Blvd Ste 115
Valencia, CA 91355-9509
Phone (661) 255-5444

Other identifiers 1

IdentifierTypeStateIssuer
GR0056130MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110726000484 CA Practitioner - Neurology 4981617263

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45233CAMDMarriage & Family Therapist
G45233CAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Clarita Neurology Medical Group Inc Neurology CurrentSince Jun 19, 2011 Accepting new patients

Locations

24355 Lyons Ave
Ste 216
Santa Clarita, CA 91321
Phone (661) 255-5444

23823 Valencia Blvd
Ste 115
Valencia, CA 91355
Phone (661) 255-5444

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1568411189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23823 VALENCIA BLVD STE 115",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913559509",
            "telephone_number": "661-255-5444",
            "fax_number": "661-255-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23823 VALENCIA BLVD STE 115",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913559509",
            "telephone_number": "661-255-5444",
            "fax_number": "661-255-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "MARK",
        "middle_name": "CLIFFORD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "G45233",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G45233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0056130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.