Mark L Shiu, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A9372 Issued in CA

Practice address

7974 Haven Ave
Suite 250
Rancho Cucamonga, CA 91730-3052

Phone

(800) 734-1733

Fax

(800) 734-1733

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gateway Medicor - Rancho Cucamonga IncGroup PAC ID 3476994666, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4
• Direct secure messaging: casacolina@direct.casacolina.org

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.

• Gateway Medicor - Rancho Cucamonga Inc.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1932974896
  Medicare reassignment Care Compare group NPD
• Medicor Medical Group, Inc

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1790863819
  Medicare reassignment NPD Authorized official
• Mountain View Emergency Physicians Medical Group, Inc.

  dba Mountain View Emergency Physicians Med Grp, Inc

  • Emergency Medicine Physician
  • Upland, CA
  • NPI 1619923653
  Medicare reassignment NPD
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Fontana, CA
  • NPI 1023306784
  Medicare reassignment NPD
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1801233036
  NPD
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1629004478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "800-734-1733",
            "fax_number": "800-734-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "800-734-1733",
            "fax_number": "800-734-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIU",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX93720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony David Shields, IMFT
• Shandreika Shields
• Karen Shigenaka
• Ellen Shin
• Chris Shitabata, DDS
• Brandi Shoemaker
• Hannah Shorr
• Irina Shostak
• Marc Shryer, D.D.S.
• Fred Shu, MD

• Family Medicine Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.