Mitsugu Shimmyo, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

110050 Issued in NY

Practice address

345 E 37TH St
Suite 203
New York, NY 10016-3256

Phone

(212) 867-5700

Fax

(212) 867-5731

NPI assigned

Oct 13, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Eye Physicians and Surgeons of Ny, PLLC

  • Ophthalmology Physician
  • Staten Island, NY
  • NPI 1366455339
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902996846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E 37TH ST",
            "address_2": "SUITE 203",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163256",
            "telephone_number": "212-867-5700",
            "fax_number": "212-867-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 37TH ST",
            "address_2": "SUITE 203",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163256",
            "telephone_number": "212-867-5700",
            "fax_number": "212-867-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMMYO",
        "first_name": "MITSUGU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "110050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00196130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tessa Mariko Shimizu, CASAC-T
• Yoshimi Shimizu
• Juliette Shimkin, LMSW
• Dana Shimkoski
• Susan M. Shimmerlik, PH.D.
• Julie Shimoni
• Daniil Shimonov, M.D.
• Mariya Shimonov, WHNP - BC
• Bertha Shimonova, PHARM.D.
• Sarah Shimonova

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.