NPIMap

Individual provider Active NPI

Fariborz Shams, D.O.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1063421865
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A6510 Issued in CA
Practice address
515 S Beach Blvd
Ste F
Anaheim, CA 92804-1812
Phone
(714) 995-7503
NPI assigned
Aug 8, 2006
Last updated
Jul 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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 20A6510 CA Primary

Addresses

Primary practice location

515 S Beach Blvd
Ste F
Anaheim, CA 92804-1812

Mailing address

515 S Beach Blvd
Ste F
Anaheim, CA 92804-1812
Phone (714) 995-7503

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
I20100830000943 CA Practitioner - Internal Medicine 1557449527 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fariborz Shams DO IncGroup PAC ID 9739267709, 3 clinicians
Family Choice Aco IncGroup PAC ID 7719379395, 60 clinicians

Practice addresses (Care Compare)

515 S Beach Blvd
Suite F
Anaheim, CA 92804-1812
Phone (714) 995-7503

7631 Wyoming St
Suite 201
Westminster, CA 92683-3904
Phone (714) 898-0765

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6510CAMDInternal Medicine Physician
6510CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Private Practice Network Inc Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Fariborz Shams, DO Inc. Internal Medicine CurrentSince Jul 16, 2002 Accepting new patients
Family Choice Aco Inc Internal Medicine CurrentSince Apr 25, 2024 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
MD Solutions Medical Corp Past Accepting new patients

Locations

515 S Beach Blvd
Ste F
Anaheim, CA 92804
Phone (714) 995-7503

30230 Rancho Viejo Rd
Ste 110
San Juan Capo, CA 92675
Phone (949) 441-5681

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Park Anaheim Healthcare CenterAnaheim, CA, CCN 555035 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 9, 2024
Jun 9, 2024
Anaheim Healthcare CenterAnaheim, CA, CCN 055984 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2019
Feb 1, 2019
Buena Park Nursing CenterBuena Park, CA, CCN 055571 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2021
Jan 1, 2021

Owned or controlled facilities with NPI records 3

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1063421865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD",
            "address_2": "STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-995-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD",
            "address_2": "STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-995-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMS",
        "first_name": "FARIBORZ",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A6510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.