Individual provider Active NPI

Mimi Shaffer, M.D.

  • Obstetrics & Gynecology Physician
  • Chula Vista, CA
National Provider Identifier
1568758928
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A123887 Issued in CA
Practice address
1400 E Palomar St
Chula Vista, CA 91913-1800
Phone
(858) 499-2702
NPI assigned
Jun 23, 2011
Last updated
Dec 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A123887 CA Primary

Addresses

Primary practice location

1400 E Palomar St
Chula Vista, CA 91913-1800

Mailing address

1400 E Palomar St
Chula Vista, CA 91913-1800
Phone (858) 499-2702

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
I20150806011378 CA Practitioner - Obstetrics/Gynecology 4183938921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
East Tennessee State University Quillen College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

1400 E Palomar St
Chula Vista, CA 91913-1800
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123887CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Dec 7, 2015 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Obstetrics & Gynecology CurrentSince Dec 7, 2015 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 24, 2015 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 24, 2015 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

1400 E Palomar St
Chula Vista, CA 91913
Phone (619) 397-3077

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

8788 Jamacha Rd
Spring Valley, CA 91977
Phone (619) 515-2380

Interoperability endpoints

  • Direct secure messaging: mshaffer34147@sharphealthcare.direct-ci.com

Organizations & group practices 8

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1568758928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E PALOMAR ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131800",
            "telephone_number": "858-499-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E PALOMAR ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131800",
            "telephone_number": "858-499-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "MIMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A123887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.