Kozue Shibazaki, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

31446 Issued in TX

Practice address

11503 NW Military Hwy
Suite 301
San Antonio, TX 78231-1884

Phone

(210) 200-9247

Fax

(210) 493-6714

NPI assigned

May 20, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Tova Rubin PHD PC

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1023368651
  NPD (past)

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1760828628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 CENTURY OAK TRL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324952",
            "telephone_number": "210-200-9247",
            "fax_number": "210-493-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11503 NW MILITARY HWY",
            "address_2": "SUITE 301",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311884",
            "telephone_number": "210-200-9247",
            "fax_number": "210-493-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBAZAKI",
        "first_name": "KOZUE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "31446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Sherwood
• Ashwin K. Shetty, M.D.
• Sachin Shetty
• Yun Shi, MD
• Andrew Shibata, MA, ATC, LAT
• Shield Texas Healthcare Inc
• Andrea McAllister Shields
• Molly Dudley Shields, M.D.
• Naomi N Shields, M.D.
• Thomas C Shields, D.D.S.

• Counseling Psychologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.