Individual provider Active NPI

Amirali Shakouripartovi, MD

  • Surgery Physician
  • Tacoma, WA
National Provider Identifier
1013563741
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60611578 Issued in WA
Practice address
801 Pacific Ave
Tacoma, WA 98402-5209
Phone
(253) 627-1001
NPI assigned
Aug 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60611578 WA Primary

Addresses

Primary practice location

801 Pacific Ave
Tacoma, WA 98402-5209

Mailing address

7225 Crescent Park W Apt 203
Playa Vista, CA 90094-2719
Phone (425) 623-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200221001505 CA Practitioner - General Surgery 3375970841 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60611578WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetica Clinique LLC CurrentSince Aug 25, 2019 Accepting new patients
County of Santa Clara CurrentSince Feb 1, 2020 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Feb 1, 2020 Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

801 Pacific Ave
Tacoma, WA 98402
Phone (229) 589-2588

Interoperability endpoints

  • Direct secure messaging: ashakouripartovi140015@santaclaravalley.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1013563741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7225 CRESCENT PARK W APT 203",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942719",
            "telephone_number": "425-623-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025209",
            "telephone_number": "253-627-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKOURIPARTOVI",
        "first_name": "AMIRALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60611578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.