Individual provider Active NPI

Clara Shayevich, N.P

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1578620050
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP6331 Issued in CA
Practice address
2320 Sutter St
Suite #101
San Francisco, CA 94115-3038
Phone
(415) 771-4072
Fax
(650) 992-1426
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP6331 CA Primary

Addresses

Primary practice location

2320 Sutter St
Suite #101
San Francisco, CA 94115-3038

Mailing address

145 Guerrero St
Suite #415
San Francisco, CA 94103-1066
Phone (415) 771-4072

Other identifiers 1

IdentifierTypeStateIssuer
NP0063310MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421001543 CA Practitioner - Nurse Practitioner 0941248686 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2186 Geary Blvd
Suite 104
San Francisco, CA 94115-3456
Phone (415) 771-4072

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP6331CAMDNurse Practitioner

Hospital & facility affiliations 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578620050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 GUERRERO ST",
            "address_2": "SUITE #415",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031066",
            "telephone_number": "415-771-4072",
            "fax_number": "650-992-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 SUTTER ST",
            "address_2": "SUITE #101",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153038",
            "telephone_number": "415-771-4072",
            "fax_number": "650-992-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYEVICH",
        "first_name": "CLARA",
        "name_prefix": "Mrs.",
        "credential": "N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP6331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0063310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.