NPIMap

Individual provider Active NPI

Patrick Edward Shipsey, M.D.

  • Emergency Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1821167545
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G86616 Issued in CA
Practice address
1990 N California Blvd
Suite 400
Walnut Creek, CA 94596-3742
Phone
(925) 225-5837
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G86616 CA Primary

Addresses

Primary practice location

1990 N California Blvd
Suite 400
Walnut Creek, CA 94596-3742

Mailing address

2140 Cal Young Rd
Eugene, OR 97401-2043
Phone (661) 496-6500

Other identifiers 1

IdentifierTypeStateIssuer
00G866160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420000900 CA Practitioner - General PracticePractitioner - Emergency Medicine 0547255291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Communities Healthcare DistrictGroup PAC ID 9133227135, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

60 Easter Ave
Weaverville, CA 96093-8054
Phone (530) 623-5541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Communities Healthcare District Current Accepting new patients
Mountain Communities Healthcare District CurrentSince Sep 6, 2016 Accepting new patients
Mountain Communities Healthcare District CurrentSince Sep 6, 2016 Accepting new patients
Mountain Emergency Physicians Medical Group Inc Emergency Medicine Past Accepting new patients
Salem Health West Valley PastSince Mar 3, 2011 Accepting new patients
Mount Eddy Emergency Physicians Medical Group, Inc. Emergency Medicine Past Accepting new patients
Sonoma Valley Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients
West Valley Hospital Pharmacy Past Accepting new patients
Bakersfield Emergency Medical Corp. Emergency Medicine Past Accepting new patients
Salem Radiology Consultants PC Past Accepting new patients
Memorial Emergency Physicians Medical Group, Inc Past Accepting new patients
North Sonoma County Health Care District Past Accepting new patients

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1821167545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 CAL YOUNG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012043",
            "telephone_number": "661-496-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 N CALIFORNIA BLVD",
            "address_2": "SUITE 400",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963742",
            "telephone_number": "925-225-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPSEY",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G86616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G866160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.