MEDICARE: DR. JESSE SHRIKI D.O

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0102X	Surgical Critical Care Physician	100519	GA
2	207P00000X	Emergency Medicine Physician	4707	AZ

General Provider Information

NPI Number	:	1689864456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSE SHRIKI D.O

Provider Business Mailing Address
First Line	:	15333 N PIMA RD STE 305
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-2717
Country	:	US
Telephone Number	:	602-703-7813
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 COLLIER RD NW STE 5015
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1721
Country	:	US
Telephone Number	:	404-605-6517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	08/20/2025

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