Individual provider Active NPI

William Rodman Shankle, MS, M.D.

  • Neurology Physician
  • Newport Beach, CA
National Provider Identifier
1932246584
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G55639 Issued in CA
Practice address
3900 W Coast Hwy Ste 310
Newport Beach, CA 92663-4093
Phone
(949) 478-8858
Fax
(949) 242-2465
NPI assigned
Jan 31, 2007
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G55639 CA Primary

Addresses

Primary practice location

3900 W Coast Hwy Ste 310
Newport Beach, CA 92663-4093

Mailing address

3900 W Coast Hwy Ste 310
Newport Beach, CA 92663-4093
Phone (949) 478-8858

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091217000599 CA Practitioner - Neurology 9234279563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Warren Alpert Medical School of Brown University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
William R Shankle MD IncGroup PAC ID 8921416280, 2 clinicians

Practice addresses (Care Compare)

369 San Miguel Dr
Suite 350
Newport Beach, CA 92660-7852

3900 W Coast Hwy
Suite 310
Newport Beach, CA 92663-4093

3900 W Coast Hwy 310
Newport Beach, CA 92663-4093

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.33 of 100Reported as individual
Quality
56.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
G55639CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William R. Shankle MD Inc. Neurology CurrentSince Feb 16, 2015 Accepting new patients

Locations

369 San Miguel Dr
Ste 350
Newport Beach, CA 92660
Phone (949) 478-8858

3900 W Coast Hwy
Ste 310
Newport Beach, CA 92663
Phone (949) 478-8858

Interoperability endpoints

  • Direct secure messaging: shankleclinic.williamrshankle@117204.advancedmd-direct.com

Organizations & group practices 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1932246584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W COAST HWY STE 310",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634093",
            "telephone_number": "949-478-8858",
            "fax_number": "949-242-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W COAST HWY STE 310",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634093",
            "telephone_number": "949-478-8858",
            "fax_number": "949-242-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKLE",
        "first_name": "WILLIAM",
        "middle_name": "RODMAN",
        "name_prefix": "Dr.",
        "credential": "MS, M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G55639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.