Shane Tashiro Matsui, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

550 South Vermont Ave.
Los Angeles, CA 90020

Phone

(213) 738-2824

Fax

(213) 427-6166

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Medicare reassignment NPD
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1417094145
  NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1992827463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912",
            "telephone_number": "213-738-2824",
            "fax_number": "213-427-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOUTH VERMONT AVE.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-738-2824",
            "fax_number": "213-427-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUI",
        "first_name": "SHANE",
        "middle_name": "TASHIRO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Hitomi Matsuda, RN
• Lynn Kato Matsuda, OD FAAO
• Sydney Matsuda
• Wendy Matsuda, P.T.
• Catherine Naomi Matsui-Barrett
• Ellen Reiko Matsumoto, OD
• Jon David Matsumoto
• Joyce Matsumoto, M.D.
• Nicole L Matsumoto, ASW
• Shuichi Matsumoto

• Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.