NPIMap

Individual provider Active NPI

Ali Shahverdiani, M.D.

  • Internal Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1063943579
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
169871 Issued in CA
Practice address
520 N Main St Ste 120
Santa Ana, CA 92701-4623
Phone
(714) 352-5800
Fax
(714) 352-5801
NPI assigned
Mar 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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 169871 CA Primary

Addresses

Primary practice location

520 N Main St Ste 120
Santa Ana, CA 92701-4623

Mailing address

520 N Main St Ste 220
Santa Ana, CA 92701-4623
Phone (714) 352-5800

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
I20210917002649 CA Practitioner - Internal Medicine 7810394855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Community Health CenterGroup PAC ID 7810394756, 29 clinicians

Practice addresses (Care Compare)

520 N Main St
Suite 120
Santa Ana, CA 92701-4623
Phone (714) 352-5800

Hospital & facility affiliations

  • Genezen Home Health Care Services, Inc Home health agency, Mission Viejo, CA, CCN 559045
  • Excel Care Home Health Services Inc Home health agency, Upland, CA, CCN 058296
  • Health Care Solutions Services, Inc Home health agency, Brea, CA, CCN 058167
  • Reliable Hospice Hospice, Murrieta, CA, CCN B21747
  • Reliable Hospice, Inc Hospice, Orange, CA, CCN 551701
  • Coastal Communities Hospital Hospital, Santa Ana, CA, CCN 050747
  • Orange County Global Medical Center Hospital, Santa Ana, CA, CCN 050746
  • Foothill Regional Medical Center Hospital, Tustin, CA, CCN 050780
  • Mesa Verde Post Acute Care Center Nursing home, Costa Mesa, CA, CCN 056362
  • Orange Healthcare & Wellness Centre, LLC Nursing home, Orange, CA, CCN 055252
  • The Hills Post Acute Nursing home, Santa Ana, CA, CCN 555765
  • Advanced Rehab Center of Tustin Nursing home, Santa Ana, CA, CCN 055330

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169871CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Center CurrentSince Oct 22, 2023 Accepting new patients
New Foundation Medical Inc. CurrentSince Sep 1, 2021 Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients

Locations

24953 Paseo de Valencia
Ste 7C
Laguna Hills, CA 92653
Phone (714) 352-5800

6960 Magnolia Ave
Ste 203
Riverside, CA 92506
Phone (714) 352-5800

520 N Main St
Ste 120
Santa Ana, CA 92701
Phone (714) 352-5800

520 N Main St
Ste 220
Santa Ana, CA 92701
Phone (714) 352-5800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Reliable Hospice, Inc.Orange, CA, CCN 551701 Hospice Contracted Managing Employee
Corporate Director
W-2 Managing Employee		 Apr 1, 2024
Apr 1, 2024
Apr 1, 2024
Reliable HospiceMurrieta, CA, CCN B21747 Hospice W-2 Managing Employee
Operational/Managerial Control		 Apr 1, 2024
Apr 1, 2024

Owned or controlled facilities with NPI records 2

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

  • Nexus Hospice Care Inc
    • Hospice and Palliative Medicine (Internal Medicine) Physician
    • Murrieta, CA
    • NPI 1053937367

    Operational/Managerial Control, W-2 Managing Employee

    CMS ownership
  • Reliable Hospice, Inc.
    • Community Based Hospice Care Agency
    • Orange, CA
    • NPI 1447537345

    Contracted Managing Employee, Corporate Director, W-2 Managing Employee

    CMS ownership

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1063943579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST STE 220",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014623",
            "telephone_number": "714-352-5800",
            "fax_number": "714-352-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST STE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014623",
            "telephone_number": "714-352-5800",
            "fax_number": "714-352-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHVERDIANI",
        "first_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "169871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.