NPIMap

Individual provider Active NPI

Javaid Ahmed Shad, M.D.

  • Gastroenterology Physician
  • Oceanside, CA
National Provider Identifier
1003885922
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G86962 Issued in CA
Practice address
3923 Waring Rd Ste a
Oceanside, CA 92056-4499
Phone
(760) 724-8782
Fax
(760) 842-7801
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G86962 CA Primary

Addresses

Primary practice location

3923 Waring Rd Ste a
Oceanside, CA 92056-4499

Mailing address

3923 Waring Rd Ste a
Oceanside, CA 92056-4499
Phone (760) 724-8782

Other identifiers 1

IdentifierTypeStateIssuer
00G869620MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ncgastro@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205001073 CA Practitioner - Gastroenterology 6709779499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North County Gastroenterology Medical Group IncGroup PAC ID 6406749167, 11 clinicians

Practice addresses (Care Compare)

3923 Waring Rd
Suite a
Oceanside, CA 92056-4499
Phone (760) 630-0529

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy45
Upper gastrointestinal (GI) endoscopy for acid reflux74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G86962CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
North County Gastroenterology Medical Group, Inc. Gastroenterology CurrentSince Dec 15, 2003 Accepting new patients
Tri-City Hospital Past Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

3923 Waring Rd
Ste A
Oceanside, CA 92056
Phone (760) 630-0529

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ncgastro@directaddress.net
  • Direct secure messaging: jshad31029@scrippshlth.medalliesdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1003885922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 WARING RD STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564499",
            "telephone_number": "760-724-8782",
            "fax_number": "760-842-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 WARING RD STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564499",
            "telephone_number": "760-724-8782",
            "fax_number": "760-842-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAD",
        "first_name": "JAVAID",
        "middle_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G86962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G869620",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncgastro@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3923 Waring Rd Ste A",
            "city": "Oceanside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920564499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.