Organization Active NPI

Karen S. Shimshak MD SC

  • Ophthalmology Physician
  • Glendale, WI
National Provider Identifier
1760528640
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
27793 Issued in WI
Legal business name
KAREN S. SHIMSHAK MD SC
Practice address
377 W River Woods Pkwy
#115
Glendale, WI 53212-1088
Phone
(414) 271-7200
Fax
(414) 271-7278
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Karen S Shimshak, MD
Title
Owner
Phone
(414) 271-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 27793 WI Primary

Addresses

Primary practice location

377 W River Woods Pkwy
#115
Glendale, WI 53212-1088

Mailing address

377 W River Woods Pkwy
#115
Glendale, WI 53212-1088
Phone (414) 271-7200

Other identifiers 2

IdentifierTypeStateIssuer
21308000MedicaidWI
DF5394OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

377 W River Woods Pkwy
#115
Glendale, WI 53212
Phone (414) 271-7200

377 W River Woods Pkwy
Ste 115
Glendale, WI 53212
Phone (414) 271-7200

2315 N Lake Dr
Ste 617
Milwaukee, WI 53211
Phone (414) 271-7200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1760528640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 W RIVER WOODS PKWY",
            "address_2": "#115",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121088",
            "telephone_number": "414-271-7200",
            "fax_number": "414-271-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 W RIVER WOODS PKWY",
            "address_2": "#115",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121088",
            "telephone_number": "414-271-7200",
            "fax_number": "414-271-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN S. SHIMSHAK MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "SHIMSHAK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-271-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "27793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21308000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF5394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.