SIMONE DESHIELDS
NPI 1083356869
Student in an Organized Health Care Education/Training Program in San Francisco, CA

Active since April 11, 2022PECOS EnrolledAccepts Medicare Assignment
1001 POTRERO AVE BLDG 80-83, SAN FRANCISCO, CA 94110(628) 206-5252 Get Directions Write a Review

NPPES record last updated: April 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Simone Deshields NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIMONE DESHIELDS (NPI 1083356869) is an individual student in an organized health care education/training program in San Francisco, California and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (2022).

NPPES Registry Identity

NPI1083356869
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSIMONE DESHIELDS
Location Address1001 POTRERO AVE BLDG 80-83San Francisco, CA 94110-3518
Mailing Address2245 John Matich DrColton, CA 92324-9513 · (909) 498-6442
Sole ProprietorYes
Medical School CMSLoma Linda University School Of MedicineGraduated 2022
Enumeration DateApril 11, 2022
NPPES CertifiedMarch 31, 2022
NPI 1083356869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1001 POTRERO AVE BLDG 80-83, San Francisco, CA 94110

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Simone Deshields is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800268053
PECOS Enrollment IDI20251021003546
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83, SFGH FAMILY HEALTH CENTER
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110
Student in an Organized Health Care Education/Training Program
1001 POTRERO AVE BLDG 80-83
SAN FRANCISCO, CA 94110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simone Deshields's NPI number?

The NPI number for Simone Deshields is 1083356869. It was assigned to this individual provider in the NPPES registry on April 11, 2022.

Where is Simone Deshields located?

Simone Deshields practices at 1001 Potrero Ave Bldg 80-83, San Francisco, CA 94110. The listed phone number is (628) 206-5252.

What is Simone Deshields's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Simone Deshields enrolled in Medicare?

Yes. Simone Deshields is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Simone Deshields was last updated on April 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.