Elizaveta Shostakovich, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

A93079 Issued in CA

Practice address

99 Montecillo Rd
San Rafael, CA 94903-3308

Phone

(415) 444-2000

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
• Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090
• UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

Merit-based Incentive Payment System (MIPS)

Final score

82.4 of 100Reported as group

Quality

65.6

Improvement activities

40

Cost

71.06

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eshostakovich242908@direct-ucsfmedicalcenter.org

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.

• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Manteca, CA
  • NPI 1689320459
  Medicare reassignment Care Compare group NPD
• Marin Hospitalist Medical Group, Inc.

  • Internal Medicine Physician
  • Greenbrae, CA
  • NPI 1023041753
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Greenbrae, CA
  • NPI 1841037850
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  Care Compare affiliation
• Sonoma Valley Health Care District

  • General Acute Care Hospital
  • Sonoma, CA
  • NPI 1710063870
  Care Compare affiliation
• University of California, San Francisco

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1689772592
  Care Compare affiliation

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1710037528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MONTECILLO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033308",
            "telephone_number": "415-444-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOSTAKOVICH",
        "first_name": "ELIZAVETA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93079",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A93079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Rd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949033308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Shevick, L.AC.
• John C Shin, M.D.
• Katherine Shine, M.S.
• Sharon Shirado, RDA
• Carolyn M. Shore, M.D.
• Barbara Shreibman, FNP
• Andrew Yu-Shin Shu
• Carolyn Beth Shulman, MSW, ACSW
• Jeremy Ross Shumaker, O.D.
• Jaydon Siao

• Hospitalist Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.