LISA YUKO SHIMOTAKE MD
NPI 1710245618
Surgery in Brooklyn, NY

Q: What is Lisa Shimotake's NPI number?

The NPI number for Lisa Shimotake is 1710245618. It was assigned to this individual provider in the NPPES registry on April 27, 2012.

Q: What is Lisa Shimotake's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Shimotake was last updated on September 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 27, 2012PECOS EnrolledAccepts Medicare Assignment

450 CLARKSON AVE # 1262, BROOKLYN, NY 11203(718) 270-8867 Get Directions Write a Review

NPPES record last updated: September 29, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lisa Yuko Shimotake Md NPPES

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

LISA YUKO SHIMOTAKE MD (NPI 1710245618) is an individual surgery provider in Brooklyn, New York, licensed in Illinois (036161155) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, is affiliated with University Of Illinois Hospital And Clinics, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1710245618

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameLISA YUKO SHIMOTAKECredential: MD

Location Address450 CLARKSON AVE # 1262Brooklyn, NY 11203-2012

Mailing Address840 S Wood StChicago, IL 60612-4325 · (312) 355-1493

Phone(718) 270-8867

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateApril 27, 2012

Last NPPES UpdateSeptember 29, 2022

NPPES CertifiedSeptember 29, 2022

✔ NPI 1710245618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IL · 036161155

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

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

450 CLARKSON AVE # 1262, Brooklyn, NY 11203

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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

Lisa Yuko Shimotake Md 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 ID8426321423

PECOS Enrollment IDI20221012002390

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Illinois Hospital And Clinics

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number140150

Location1740 West Taylor St Suite 1400Chicago, IL 60612 · Cook County

Emergency services Birthing friendly

Osf Little Company Of Mary Medical Center

Acute Care Hospitals · Evergreen Park, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140179

Location2800 W 95th StEvergreen Park, IL 60805 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11203 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

Most-billed visit code 99213

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

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.

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