Individual provider Active NPI

Desmond Shapiro, M.D.

  • Specialist
  • Santa Rosa, CA
National Provider Identifier
1720043268
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A26474 Issued in CA
Practice address
2301 Circadian Way
Suite a
Santa Rosa, CA 95407-5416
Phone
(707) 526-2027
Fax
(707) 526-2096
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A26474 CA Primary

Addresses

Primary practice location

2301 Circadian Way
Suite a
Santa Rosa, CA 95407-5416

Mailing address

2301 Circadian Way
Suite a
Santa Rosa, CA 95407-5416
Phone (707) 526-2027

Other identifiers 2

IdentifierTypeStateIssuer
A26474OtherCALICENSE
00A264740MedicaidCA

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Specialist Current Accepting new patients

Locations

2301 Circadian Way
Ste A
Santa Rosa, CA 95407
Phone (707) 526-2027

232 Hospital Dr
Ste A
Ukiah, CA 95482
Phone (707) 463-2121

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/BGAJAA

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, 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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1720043268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CIRCADIAN WAY",
            "address_2": "SUITE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075416",
            "telephone_number": "707-526-2027",
            "fax_number": "707-526-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CIRCADIAN WAY",
            "address_2": "SUITE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075416",
            "telephone_number": "707-526-2027",
            "fax_number": "707-526-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "DESMOND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A26474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A26474",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A264740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.