1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. General Practice
  6. NPI Profile

JEFFREY SHIBATA
NPI 1619615929
General Practice in Los Angeles, CA

Active since May 25, 2022PECOS Enrolled
222 S CENTRAL AVE APT 415, LOS ANGELES, CA 90012(805) 506-5333 Get Directions Write a Review

NPPES record last updated: November 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 15, 2024, May 25, 2022 (2 updates tracked since 2022).

About Jeffrey Shibata NPPES

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

JEFFREY SHIBATA (NPI 1619615929) is an individual general practice provider in Los Angeles, California, licensed in California (1619615929) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Los Angeles.

NPPES Registry Identity

NPI1619615929
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameJEFFREY SHIBATA
Location Address222 S CENTRAL AVE APT 415Los Angeles, CA 90012-4235
Mailing Address222 S Central Ave Apt 415Los Angeles, CA 90012-4235
Phone(805) 506-5333
Sole ProprietorNo
Enumeration DateMay 25, 2022
Last NPPES UpdateNovember 15, 20242 updates tracked since enumeration
NPPES CertifiedNovember 15, 2024
✔ NPI 1619615929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · 1619615929
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
222 S CENTRAL AVE APT 415, Los Angeles, CA 90012
Open in Google Maps ↗

Secondary Practice Location 1

Location 112021 Wilmington AveLos Angeles, CA 90059-3019 · Phone (424) 338-8714

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Shibata is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Jeffrey Shibata's NPI number?

The NPI number for Jeffrey Shibata is 1619615929. It was assigned to this individual provider in the NPPES registry on May 25, 2022.

Where is Jeffrey Shibata located?

Jeffrey Shibata practices at 222 S Central Ave Apt 415, Los Angeles, CA 90012. The listed phone number is (805) 506-5333.

What is Jeffrey Shibata's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jeffrey Shibata enrolled in Medicare?

Yes. Jeffrey Shibata is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeffrey Shibata was last updated on November 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.