Organization Active NPI

Shlomi Albert MD Inc

  • Urology Physician
  • Fountain Valley, CA
National Provider Identifier
1063725968
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A99515 Issued in CA
Legal business name
SHLOMI ALBERT MD INC
Practice address
11160 Warner Ave
Suite 423
Fountain Valley, CA 92708-4056
Phone
(714) 549-3333
Fax
(714) 549-3334
NPI assigned
Jul 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Dr. Shlomim Albert, M.D.
Title
President
Phone
(714) 549-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A99515 CA Primary

Addresses

Primary practice location

11160 Warner Ave
Suite 423
Fountain Valley, CA 92708-4056

Mailing address

11160 Warner Ave
Suite 423
Fountain Valley, CA 92708-4056
Phone (714) 549-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221001162 CA Part B Supplier - Clinic/Group Practice 8224226980 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2034456Shlomi Albert MD Inc11160 Warner Ave. Ste 423, Fountain Valley, CA 92708Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory

Locations

11160 Warner Ave
Ste 423
Fountain Vly, CA 92708
Phone (714) 549-3333

Interoperability endpoints

  • Direct secure messaging: shlomialbert@shlomialbertmd.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1063725968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 423",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084056",
            "telephone_number": "714-549-3333",
            "fax_number": "714-549-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 423",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084056",
            "telephone_number": "714-549-3333",
            "fax_number": "714-549-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHLOMI ALBERT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "ALBERT",
        "authorized_official_first_name": "SHLOMIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-549-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A99515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.