Individual provider Active NPI

Neeka Shayan

  • Internal Medicine Physician
  • Colton, CA
National Provider Identifier
1023404365
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
390200000 Issued in CA
Practice address
400 N Pepper Ave Ste 204
Colton, CA 92324-1801
Phone
(909) 580-6266
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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 390200000 CA Primary

Addresses

Primary practice location

400 N Pepper Ave Ste 204
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave Ste 204
Colton, CA 92324-1801

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20190404000664 CA Practitioner - Internal Medicine 4284975095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3401 S Harbor Blvd
Santa Ana, CA 92704-7933
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
390200000CAMDObstetrics & Gynecology Physician
15576CAMDHealth Service Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Kansal Inc Internal Medicine CurrentSince Oct 20, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 7, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 7, 2023 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

5900 W Olympic Blvd
Los Angeles, CA 90036
Phone (310) 267-2680

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

2550 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 529-8000

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002

660 4th St
San Francisco, CA 94107
Phone (415) 349-0850

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1426 Montana Ave
Ste 2
Santa Monica, CA 90403
Phone (310) 388-6798

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 6

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1023404365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE STE 204",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE STE 204",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYAN",
        "first_name": "NEEKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "390200000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.