Jeffrey S Shilt, MD

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

M10261 Issued in ID

Practice address

703 S Americana Blvd
Ste 120
Boise, ID 83702-5099

Phone

(208) 323-2600

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshilt215163@prddirect.texaschildrens.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.

• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1730165366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S AMERICANA BLVD",
            "address_2": "STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025099",
            "telephone_number": "208-323-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILT",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "9901473",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "ID",
            "license": "M10261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200043936",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xiaoming Shi, MD
• Katrina Shibambo
• Joshua Shieh
• Ali Shields, LCSW
• Michaela Shields, PSYD
• Keita Shimada, MK, LAT, ATC
• Diana San Juan Shimko, CRNA
• Jane M Shimon, ED.D., A.T.C.
• Daniel Shin, DO
• Krista Shindledecker, SLP

• Pediatric Orthopaedic Surgery Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Orthopaedic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.

Verify at the official NPI Registry.