Individual provider Active NPI

Shaina Nishimura, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Philadelphia, PA
National Provider Identifier
1700089786
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AT006107 Issued in PA
Practice address
8100 Roosevelt Blvd
Suite 202
Philadelphia, PA 19152-2900
Phone
(215) 535-5598
NPI assigned
Jun 7, 2007
Last updated
Apr 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0021291 NY
Audiologist-Hearing Aid Fitter 237600000X 25MG00114200 NJ
Audiologist-Hearing Aid Fitter 237600000X AT006107 PA Primary
Assistive Technology Practitioner Audiologist 231HA2400X AT006107 PA
Assistive Technology Supplier Audiologist 231HA2500X AT006107 PA
Audiologist 231H00000X 41YA00073700 NJ

Addresses

Primary practice location

8100 Roosevelt Blvd
Suite 202
Philadelphia, PA 19152-2900

Mailing address

719 Hunters LN
Mount Laurel, NJ 08054-2814
Phone (609) 320-3332

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

State licenses

LicenseStateTypeSpecialty
41YA00073700NJMDAudiologist
0021291NYMDAudiologist
AT006107PAMDAssistive Technology Practitioner Audiologist
25MG00114200NJMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist Past Accepting new patients
Rem Audiology Associates, P.C. Audiologist Past Accepting new patients

Organizations & group practices 2

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1700089786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 HUNTERS LN",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542814",
            "telephone_number": "609-320-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ROOSEVELT BLVD",
            "address_2": "SUITE 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522900",
            "telephone_number": "215-535-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMURA",
        "first_name": "SHAINA",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "0021291",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00114200",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": "AT006107",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "PA",
            "license": "AT006107",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "PA",
            "license": "AT006107",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00073700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.