NPIMap

Individual provider Active NPI

Keyvan Shirazi, M.D.

  • Internal Medicine Physician
  • Encino, CA
National Provider Identifier
1023033107
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A78184 Issued in CA
Practice address
16952 Ventura Blvd
Encino, CA 91316-4197
Phone
(818) 789-3964
Fax
(818) 789-3967
NPI assigned
Jul 12, 2006
Last updated
Sep 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A78184 CA Primary

Addresses

Primary practice location

16952 Ventura Blvd
Encino, CA 91316-4197

Mailing address

16952 Ventura Blvd.
Encino, CA 91316
Phone (818) 789-3964

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
I20060302000691 CA Practitioner - Internal Medicine 8426064296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shiraz Medical Group IncGroup PAC ID 3274561600, 4 clinicians

Practice addresses (Care Compare)

16952 Ventura Blvd
Suite 100
Encino, CA 91316-4193
Phone (818) 789-3964

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shiraz Medical Group, Inc Current Accepting new patients
Shiraz Medical Group, Inc Internal Medicine CurrentSince Jun 3, 2003 Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Dignity Community Care Past Accepting new patients
Nightfall Healthcare, Inc. PastSince Feb 1, 2023 Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients

Locations

16952 Ventura Blvd
Encino, CA 91316
Phone (818) 789-3964

16952 Ventura Blvd
Ste 100
Encino, CA 91316
Phone (818) 789-3964

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tarzana Health and Rehabilitation CenterTarzana, CA, CCN 056124 Skilled nursing facility Adp of the SNF Sep 11, 2025
Lake Balboa Care CenterVan Nuys, CA, CCN 056180 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Feb 1, 2023
Feb 1, 2023
Feb 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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

Hospital & facility affiliations 11

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1023033107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD.",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "KEYVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.