Individual provider Active NPI

Michael Aaron Shamoon, MD

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1053722389
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A154196 Issued in CA
Practice address
1200 N State St RM 1011
Los Angeles, CA 90089-1001
Phone
(323) 409-6667
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A154196 CA Primary

Addresses

Primary practice location

1200 N State St RM 1011
Los Angeles, CA 90089-1001

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-2121

Other practice location 1

550 1st Ave
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506

Other practice location 2

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 977-2121

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
I20180410001842 CA Practitioner - Emergency Medicine 8426356403 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154196CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1200 N State St
Rm 1011
Los Angeles, CA 90089
Phone (323) 226-6667

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

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.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1053722389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST RM 1011",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "323-409-6667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_2": "NYU Langone Medical Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90017",
            "country_code": "US",
            "telephone_number": "213-977-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMOON",
        "first_name": "MICHAEL",
        "middle_name": "AARON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A154196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.