Active NPI
Budd Norman Shenkin, MD
- Pediatrics Physician
- Oakland, CA
National Provider Identifier
1639138118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G18425
- Practice address
- 3100 Telegraph Ave
2ND Floor
Oakland, CA 94609-3210 - Phone
- (510) 452-5231
- Fax
- (510) 869-6679
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G18425 | CA | Primary |
Addresses
Primary practice location
3100 Telegraph Ave
2ND Floor
Oakland, CA 94609-3210
Mailing address
11875 Dublin Blvd
Suite C 140
Dublin, CA 94568-2843
Phone (925) 587-2505
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G184250 | Other | MEDICARE PTAN | |
| 00G184255 | Other | MEDICARE - PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LPCH Medical Group Div of Lucile | Pediatrics | Past | Accepting new patients |
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": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352764800000",
"number": "1639138118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11875 DUBLIN BLVD",
"address_2": "SUITE C 140",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682843",
"telephone_number": "925-587-2505",
"fax_number": "925-587-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 TELEGRAPH AVE",
"address_2": "2ND FLOOR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093210",
"telephone_number": "510-452-5231",
"fax_number": "510-869-6679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENKIN",
"first_name": "BUDD",
"middle_name": "NORMAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2012-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G18425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "00G184250",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - PTAN",
"identifier": "00G184255",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.