Active NPI
Gail M Shiomoto, M.D.
- Hematology & Oncology Physician
- Chicago, IL
National Provider Identifier
1700872074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Practice address
- 1501 S California Ave
Chicago, IL 60608-1732 - Phone
- (773) 257-6110
- NPI assigned
- Sep 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | IL | Primary |
Addresses
Primary practice location
1501 S California Ave
Chicago, IL 60608-1732
Mailing address
5955 Hickory CT
Johnston, IA 50131-1621
Phone (515) 296-2407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-047731-1 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130716000399 | IA | Order and Referring Only - Hematology/Oncology | 6507839461 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-047731 | IL | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700872074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 HICKORY CT",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501311621",
"telephone_number": "515-296-2407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081732",
"telephone_number": "773-257-6110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIOMOTO",
"first_name": "GAIL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-047731-1",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.