Individual provider Active NPI

David G Shainberg, DPM

  • Podiatrist
  • Memphis, TN
National Provider Identifier
1629048111
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
491 Issued in TN
Practice address
993 Reddoch CV
Memphis, TN 38119-3614
Phone
(901) 681-9141
Fax
(901) 681-9149
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 491 TN Primary

Addresses

Primary practice location

993 Reddoch CV
Memphis, TN 38119-3614

Mailing address

993 Reddoch CV
Memphis, TN 38119-3614
Phone (901) 681-9141

Other identifiers 3

IdentifierTypeStateIssuer
152306717MedicaidAR
480034635OtherTNMEDICARE ID TYPE UNSPECIFIED
3352609MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111102000497 TN Practitioner - Podiatry 5395726996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poplar Podiatry PCGroup PAC ID 4587645163, 2 clinicians

Practice addresses (Care Compare)

1038 S Yates Rd
Memphis, TN 38119-3708
Phone (901) 681-9141

Merit-based Incentive Payment System (MIPS)

Final score
78.99 of 100Reported as individual
Quality
57.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue88
Removal of skin lesions1-10
Removal of nail tissue158
Removal or shaving of skin growth346
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
491TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Podiatry PC Podiatrist CurrentSince Sep 1, 2002 Accepting new patients

Locations

228 W Tyler Ave
West Memphis, AR 72301
Phone (870) 635-0369

228 W Tyler Ave
Ste 104
West Memphis, AR 72301
Phone (870) 735-6500

993 Reddoch Cv
Memphis, TN 38119
Phone (901) 681-9141

1038 S Yates Rd
Memphis, TN 38119
Phone (901) 472-4100

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1629048111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 REDDOCH CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193614",
            "telephone_number": "901-681-9141",
            "fax_number": "901-681-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 REDDOCH CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193614",
            "telephone_number": "901-681-9141",
            "fax_number": "901-681-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAINBERG",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152306717",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "480034635",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3352609",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.