Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Yuko Shimotake, MD

Individual provider Surgery Physician · NPI 1710245618

Lisa Yuko Shimotake, MD is a General Surgery in Brooklyn, New York. Qualified in 2012, 14 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2012
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone: (718) 270-8867
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036161155 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1710245618
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 27, 2012
Last updated in NPPESSeptember 29, 2022
Certification dateSeptember 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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