Individual provider Active NPI

Frederic Carl Bishko, M.D.

  • Rheumatology Physician
  • Shaker Heights, OH
National Provider Identifier
1639317696
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
35. 028342 Issued in OH
Practice address
2679 Rocklyn Rd
Shaker Heights, OH 44122-2112
Phone
(216) 831-0390
Fax
(216) 464-3929
NPI assigned
Jan 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 35. 028342 OH Primary

Addresses

Primary practice location

2679 Rocklyn Rd
Shaker Heights, OH 44122-2112

Mailing address

2679 Rocklyn Rd
Shaker Heights, OH 44122-2112
Phone (216) 831-0390

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35. 028342OHMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1639317696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2679 ROCKLYN RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441222112",
            "telephone_number": "216-831-0390",
            "fax_number": "216-464-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2679 ROCKLYN RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441222112",
            "telephone_number": "216-831-0390",
            "fax_number": "216-464-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHKO",
        "first_name": "FREDERIC",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "35. 028342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.