Individual provider Active NPI

Junichi Shimamura, M.D.

  • Surgery Physician
  • Valhalla, NY
National Provider Identifier
1962109702
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
324555 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-8381
NPI assigned
Feb 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 324555 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

1767 North Decatur Rd NE
University Inn at Emory Unit 410
Atlanta, GA 30307
Phone (678) 920-4471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230718000443 NY Practitioner - Thoracic SurgeryPractitioner - General Surgery 8527428945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)26
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324555NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC Surgery CurrentSince Jul 1, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jul 1, 2023 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

Hospital & facility affiliations 2

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1962109702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 NORTH DECATUR RD NE",
            "address_2": "UNIVERSITY INN AT EMORY UNIT 410",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30307",
            "telephone_number": "678-920-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMAMURA",
        "first_name": "JUNICHI",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "324555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.