Jean Shimanek, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

91307 Issued in NM

Practice address

101 Hospital LP NE
Ste 214
Albuq, NM 87109-2128

Phone

(505) 883-6600

Fax

(505) 883-0023

NPI assigned

Jun 6, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jshimanek31754@ahs.direct-ci.com

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.

• Angela L Drury PC

  • Foot & Ankle Surgery Podiatrist
  • Albuquerque, NM
  • NPI 1932337557
  NPD (past)
• Santa Fe Radiology PC

  • Diagnostic Radiology Physician
  • Santa Fe, NM
  • NPI 1760402127
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1891734547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL LP NE",
            "address_2": "STE 214",
            "city": "ALBUQ",
            "state": "NM",
            "postal_code": "871092128",
            "telephone_number": "505-883-6600",
            "fax_number": "505-883-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL LP NE",
            "address_2": "STE 214",
            "city": "ALBUQ",
            "state": "NM",
            "postal_code": "871092128",
            "telephone_number": "505-883-6600",
            "fax_number": "505-883-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMANEK",
        "first_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NM",
            "license": "91307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086S0122X",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "741440546305",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E2086",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bear Canyon Health Circle
• Ear Associates PC
• Mary R. Gomez, LADAC

• All providers in Albuq, NM
• Plastic and Reconstructive Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.