Active NPI
Alex Paul Shimkus, CPO
- Orthotist
- San Francisco, CA
National Provider Identifier
1649730128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- CPO03903
- Practice address
- 2550 23Rd St RM 119
San Francisco, CA 94110-3504 - Phone
- (415) 206-4387
- Fax
- (415) 206-4389
- NPI assigned
- Mar 21, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | CPO03903 | ||
| Orthotist | 222Z00000X | CPO03903 | Primary |
Addresses
Primary practice location
2550 23Rd St RM 119
San Francisco, CA 94110-3504
Mailing address
2550 23Rd St RM 119
San Francisco, CA 94110-3504
Phone (415) 206-4387
Other practice location 1
2550 23rd St Rm 119
San Francisco, CA 94110-3504
Phone (415) 206-4387
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPO03903 | Other | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC. |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553126400000",
"number": "1649730128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 23RD ST RM 119",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941103504",
"telephone_number": "415-206-4387",
"fax_number": "415-206-4389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 23RD ST RM 119",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941103504",
"telephone_number": "415-206-4387",
"fax_number": "415-206-4389"
}
],
"practiceLocations": [
{
"address_1": "2550 23rd St Rm 119",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941103504",
"country_code": "US",
"telephone_number": "415-206-4387",
"fax_number": "415-206-4389",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIMKUS",
"first_name": "ALEX",
"middle_name": "PAUL",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-21",
"last_updated": "2019-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": "CPO03903",
"primary": false
},
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": "CPO03903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC.",
"identifier": "CPO03903",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.