Individual provider Active NPI

Marc S Shiffman, MD

  • Internal Medicine Physician
  • Frisco, CO
National Provider Identifier
1639171440
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41574 Issued in CO
Practice address
730 Summit Blvd
101
Frisco, CO 80443
Phone
(970) 668-3911
Fax
(970) 668-5650
NPI assigned
Aug 11, 2005
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41574 CO Primary

Addresses

Primary practice location

730 Summit Blvd
101
Frisco, CO 80443

Mailing address

PO Box 4009
Frisco, CO 80443-4009
Phone (970) 668-3911

Other identifiers 1

IdentifierTypeStateIssuer
73431273MedicaidCO

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

State licenses

LicenseStateTypeSpecialty
41574COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Mountain Medical, PC Internal Medicine PastSince Aug 1, 2008 Accepting new patients
Summit Internal Medicine, PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1639171440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4009",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804434009",
            "telephone_number": "970-668-3911",
            "fax_number": "970-668-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SUMMIT BLVD",
            "address_2": "101",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-3911",
            "fax_number": "970-668-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFMAN",
        "first_name": "MARC",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "41574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73431273",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.