NPIMap

Individual provider Active NPI

Shakeh A Mazmanian, MD

  • Pediatrics Physician
  • La Canada, CA
National Provider Identifier
1033182902
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G78126 Issued in CA
Practice address
1346 Foothill Blvd
Suite 201
La Canada, CA 91011-2122
Phone
(818) 790-5583
Fax
(818) 790-9517
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G78126 CA Primary

Addresses

Primary practice location

1346 Foothill Blvd
Suite 201
La Canada, CA 91011-2122

Mailing address

133 N Altadena Dr
2ND Floor
Pasadena, CA 91107-7325
Phone (626) 397-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G78126CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital of Los Angeles Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
CHHP Holdings II, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Huntington Medical Foundation Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: smazmanian412988@direct.cshs.org

Organizations & group practices 7

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1033182902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N ALTADENA DR",
            "address_2": "2ND FLOOR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911077325",
            "telephone_number": "626-397-8335",
            "fax_number": "626-397-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILL BLVD",
            "address_2": "SUITE 201",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112122",
            "telephone_number": "818-790-5583",
            "fax_number": "818-790-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZMANIAN",
        "first_name": "SHAKEH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G78126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.