Individual provider Active NPI

Joel Shilyansky, MD

  • Pediatric Surgery Physician
  • Iowa City, IA
National Provider Identifier
1942251368
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
37045 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-1763
Fax
(319) 356-8378
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 42790 WI
Pediatric Surgery Physician 2086S0120X 37045 IA Primary
Surgery Physician 208600000X 37045 IA

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1763

Other identifiers 3

IdentifierTypeStateIssuer
0749655MedicaidIA
29490OtherIAWELLMARK BCBS
34019800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20070319000227 IA Practitioner - General SurgeryPractitioner - General PracticePractitioner - Thoracic Surgery 6204939994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42790WIMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Surgery CurrentSince Jan 24, 2007 Accepting new patients
State University of Iowa Past Accepting new patients
State University of Iowa Past Accepting new patients

Locations

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

Interoperability endpoints

  • Direct secure messaging: jshilyansky21487@uihcdirect.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1942251368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1763",
            "fax_number": "319-356-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1763",
            "fax_number": "319-356-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILYANSKY",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WI",
            "license": "42790",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IA",
            "license": "37045",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "37045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0749655",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "29490",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34019800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.