NPIMap

Individual provider Active NPI

Shelby D Rifkin, MD

  • Hematology & Oncology Physician
  • Jefferson City, MO
National Provider Identifier
1639166481
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
21520-20 Issued in WI
Practice address
1432 Southwest Blvd
Jefferson City, MO 65109-2444
Phone
(573) 632-4800
Fax
(573) 632-5874
NPI assigned
Oct 5, 2005
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-043437 IL
Hematology (Internal Medicine) Physician 207RH0000X 036-043437 IL
Hematology & Oncology Physician 207RH0003X 21520-20 WI Primary
Hematology & Oncology Physician 207RH0003X 036043437 IL

Addresses

Primary practice location

1432 Southwest Blvd
Jefferson City, MO 65109-2444

Mailing address

PO Box 1128
Jefferson City, MO 65102-1128
Phone (573) 632-4800

Other identifiers 2

IdentifierTypeStateIssuer
036-043437MedicaidIL
123240003OtherMOMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shelby.rifkin@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20141112002326 TN Practitioner - Hematology/Oncology 8123928306 Reassigns benefits to 1 organization
I20150609001683 IL Practitioner - Hematology/Oncology 8123928306 Reassigns benefits to 2 organizations
I20161108000194 WI Practitioner - Hematology/Oncology 8123928306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-043437ILMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jul 15, 2019 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Cook County Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Oct 31, 2016 Accepting new patients
Thompson Oncology Group Hematology & Oncology CurrentSince Jan 7, 2019 Accepting new patients
Northwest Community Hospital Current Accepting new patients
Cook County Internal Medicine CurrentSince Sep 20, 2019 Accepting new patients
Cook County CurrentSince Sep 20, 2019 Accepting new patients
Illinois Cancer Specialists Hematology & Oncology Past Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

Dept 888078
Knoxville, TN 37995

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3809 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-5000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: shelby.rifkin@direct.ccprovider.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1639166481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021128",
            "telephone_number": "573-632-4800",
            "fax_number": "573-632-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 SOUTHWEST BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092444",
            "telephone_number": "573-632-4800",
            "fax_number": "573-632-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIFKIN",
        "first_name": "SHELBY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-043437",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "IL",
            "license": "036-043437",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "21520-20",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036043437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-043437",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "123240003",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelby.rifkin@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.