Individual provider Active NPI

Michaela Noel Pittock Shouldis

  • Reproductive Endocrinology Physician
  • San Mateo, CA
National Provider Identifier
1659233120
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
95292282 Issued in CA
Practice address
1100 Park PL
San Mateo, CA 94403-1599
Phone
(971) 241-5190
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 95292282 CA Primary

Addresses

Primary practice location

1100 Park PL
San Mateo, CA 94403-1599

Mailing address

475 Justin Dr
San Francisco, CA 94112-1132
Phone (971) 241-5190

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

State licenses

LicenseStateTypeSpecialty
95292282CAMDReproductive Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1659233120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 JUSTIN DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121132",
            "telephone_number": "971-241-5190",
            "fax_number": "971-241-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PARK PL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031599",
            "telephone_number": "971-241-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDIS",
        "first_name": "MICHAELA",
        "middle_name": "NOEL PITTOCK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CA",
            "license": "95292282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.