Individual provider Active NPI

Alexey Shikuev, MD

  • Neurology Physician
  • Renton, WA
National Provider Identifier
1609309541
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD61309065 Issued in WA
Practice address
4033 Talbot Rd S Ste 520
Renton, WA 98055-5774
Phone
(425) 690-3586
Fax
(425) 690-9586
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD61309065 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 520
Renton, WA 98055-5774

Mailing address

4033 Talbot Rd S Ste 520
Renton, WA 98055-5774
Phone (425) 690-3586

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-2051

Other identifiers 1

IdentifierTypeStateIssuer
2215233MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220921001476 WA Practitioner - Neurology 6901143940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

4033 Talbot Rd S
Suite 520
Renton, WA 98055-5774
Phone 42565655662

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61309065WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Neurology CurrentSince Sep 1, 2022 Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4033 Talbot Rd S
Ste 520
Renton, WA 98055
Phone (425) 255-1999

3600 Lind Ave SW
Ste 100
Renton, WA 98057

Interoperability endpoints

  • Direct secure messaging: ashikuev99563@direct.valleymed.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1609309541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 520",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555774",
            "telephone_number": "425-690-3586",
            "fax_number": "425-690-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 520",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555774",
            "telephone_number": "425-690-3586",
            "fax_number": "425-690-9586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-2051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIKUEV",
        "first_name": "ALEXEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61309065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2215233",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.