Mitchell Samuel Shulkin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

CA8153T Issued in CA

Practice address

11835 Carmel Mountain Rd
Suite 1313
San Diego, CA 92128-4609

Phone

(858) 674-1276

Fax

(858) 674-6060

NPI assigned

May 4, 2006

Last updated

Jan 11, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1770531865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 CARMEL MOUNTAIN RD",
            "address_2": "SUITE 1313",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284609",
            "telephone_number": "858-674-1276",
            "fax_number": "858-674-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 CARMEL MOUNTAIN RD",
            "address_2": "SUITE 1313",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284609",
            "telephone_number": "858-674-1276",
            "fax_number": "858-674-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULKIN",
        "first_name": "MITCHELL",
        "middle_name": "SAMUEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA8153T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0081530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorretta Shughrue
• Brian Shui, D.C.
• Sweety Shukla
• Lisa Shuldberg, LPCC
• Esther Shuler
• Kristina Nicole Shull, RN
• Danielle Shulman, OT
• Mark A Shulman, DPT
• Adam Michael Shults, PA-C
• Karen L. Shultz, RN

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.