Yuriy Shpak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2570 Issued in NV

Practice address

10291 McClure Ave
Garden Grove, CA 92843-5013

Phone

(714) 914-6618

NPI assigned

Nov 19, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1679550149
  Medicare reassignment
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • North Las Vegas, NV
  • NPI 1316488141

  Physician Assistant

  NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1366429821

  Physician Assistant

  NPD

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1902563331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10291 MCCLURE AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435013",
            "telephone_number": "714-914-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10291 MCCLURE AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435013",
            "telephone_number": "714-914-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHPAK",
        "first_name": "YURIY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Shiroyama
• Shivawn Inc.
• Dua Shoaib
• James S Shon, DDS
• Shopswirl LLC
• Yuan Shui
• Elizabeth Antonia Siapno
• Daria Sib-Frazer
• Carlos Sicat
• Rupal S. Sidhu

• Physician Assistant in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.