Kelly H. Shimokusu, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A67097 Issued in CA

Practice address

900 Hyde St
San Francisco, CA 94109-4806

Phone

(415) 353-6000

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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: 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

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.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Mills Peninsula Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Burlingame, CA
  • NPI 1841226529
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Redwood City, CA
  • NPI 1487609996
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Mills Peninsula Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • San Mateo, CA
  • NPI 1548298318
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1801800834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HYDE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094806",
            "telephone_number": "415-353-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMOKUSU",
        "first_name": "KELLY",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A67097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A670970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ekaterina Shimchuk
• Jessica Anne Shimerdla, PHARMD
• Demi Pham Shimizu, DDS
• Erika Shimizu, ASW
• Alex Paul Shimkus, CPO
• Janet CHI-Jane Shimotake, M.D.
• Thomas K. Shimotake, M.D.
• Jung Shin Robin, D.D.S.
• Changsub Alex Shin, PH.D., L.AC., P.T.
• Jaehoon Shin, M.D., PH.D.

• Emergency Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.