DR. GREGORY SHOICHI ISHIMOTO M.D.
NPI 1164681896
Family Medicine in Manitowoc, WI

Q: What is Gregory Ishimoto's NPI number?

The NPI number for Gregory Ishimoto is 1164681896. It was assigned to this individual provider in the NPPES registry on June 6, 2008.

Q: What is Gregory Ishimoto's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gregory Ishimoto was last updated on August 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since June 06, 2008PECOS EnrolledAccepts Medicare Assignment

4100 DEWEY ST, MANITOWOC, WI 54220(805) 624-0615 Get Directions Write a Review

NPPES record last updated: August 29, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Gregory Shoichi Ishimoto M.d. NPPES

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

DR. GREGORY SHOICHI ISHIMOTO M.D. (NPI 1164681896) is an individual family medicine provider in Manitowoc, Wisconsin, licensed in Wisconsin (56106-020) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2006).

NPPES Registry Identity

NPI1164681896

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. GREGORY SHOICHI ISHIMOTOCredential: M.D.

Location Address4100 DEWEY STManitowoc, WI 54220-5497

Mailing Address4100 Dewey StManitowoc, WI 54220-5497 · (805) 624-0615

Phone(805) 624-0615

Sole ProprietorNo

Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2006

Enumeration DateJune 6, 2008

Last NPPES UpdateAugust 29, 2011

✔ NPI 1164681896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 56106-020

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4100 DEWEY ST, Manitowoc, WI 54220

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gregory Shoichi Ishimoto M.d. 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 ID9032264965

PECOS Enrollment IDI20090828000369, I20110919000599

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.

Medicare Billing Reassignments

Medicare enrollment records show Gregory Ishimoto reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orchard Hospital

1,774 mi

Critical Access

240 SPRUCE ST
Gridley, CA 95948

Reassigned Medicare billing, California enrollment
17 clinicians in this Medicare group

NPI 1477522019 (530) 846-9000

County Of Ventura

1,786 mi

Community/Behavioral Health

1900 E LOS ANGELES AVE STE 100
Simi Valley, CA 93065

Reassigned Medicare billing, California enrollment
710 clinicians in this Medicare group

NPI 1013139658 (805) 577-1724

American Specialty Physicians Group Inc

1,786 mi

Emergency Medicine

700 17TH ST STE 205
Modesto, CA 95354

Reassigned Medicare billing, California enrollment
180 clinicians in this Medicare group

NPI 1164363024 (877) 346-2211

Glenn Medical Center, LLC

1,796 mi

Medicare Defined Swing Bed Unit

1133 W SYCAMORE ST
Willows, CA 95988

Reassigned Medicare billing, California enrollment
53 clinicians in this Medicare group

NPI 1336187178 (530) 934-1800

Sonoma Valley Emergency Physicians Medical Group, Inc

1,842 mi

Emergency Medicine

347 ANDRIEUX ST
Sonoma, CA 95476

Reassigned Medicare billing, California enrollment
112 clinicians in this Medicare group

NPI 1710164629 (330) 493-4443

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

115 services114 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

111 services107 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

69 services69 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

67 services65 patients

Emergency department visit with straightforward medical decision making 99282

An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.

28 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54220 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers13 claims13 services$17.66 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers16 claims16 services$98.83 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers28 claims28 services$21.77 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

ANDREA JO POULSON-PORT M.D.

Family Medicine