NPIMap

Individual provider Active NPI

Nikita Mukesh Shah, MD

  • Surgical Oncology Physician
  • Thousand Oaks, CA
National Provider Identifier
1073889002
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
A170065 Issued in CA
Practice address
425 Haaland Dr Ste 101
Thousand Oaks, CA 91361-5230
Phone
(805) 496-2949
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R7322 TX
Surgery Physician 208600000X 4301112575 MI
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Oncology Physician 2086X0206X A170065 CA Primary

Addresses

Primary practice location

425 Haaland Dr Ste 101
Thousand Oaks, CA 91361-5230

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Other practice location 1

1500 E Medical Center Dr
1st floor Cancer Center
Ann Arbor, MI 48109-5916
Phone (734) 936-6000

Other practice location 2

1350 First Colony Blvd
Sugar Land, TX 77479-4308
Phone (281) 277-5200

Other identifiers 1

IdentifierTypeStateIssuer
387124602MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

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
I20200914002780 CA Practitioner - Surgical Oncology 1951672831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

425 Haaland Dr
Suite 101
Thousand Oaks, CA 91361-5230
Phone (805) 496-2949

Hospital & facility affiliations

  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236
  • City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146
  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
78.51
Promoting interoperability
100
Improvement activities
40
Cost
70.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy31
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation Surgery CurrentSince Sep 4, 2020 Accepting new patients
Houston Methodist St. John Hospital Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients
Chca Clear Lake LP Past Accepting new patients
West Hills Hospital Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Christus Health Gulf Coast Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

1157 Swallow Ln
Simi Valley, CA 93065
Phone (805) 527-2770

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

425 Haaland Dr
Ste 101
Thousand Oaks, CA 91361
Phone (805) 496-2949

Interoperability endpoints

  • Direct secure messaging: direct@cityofhope.direct-ci.com

Organizations & group practices 10

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 4

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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1073889002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HAALAND DR STE 101",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913615230",
            "telephone_number": "805-496-2949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_2": "1st floor Cancer Center",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095916",
            "country_code": "US",
            "telephone_number": "734-936-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 First Colony Blvd",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774794308",
            "country_code": "US",
            "telephone_number": "281-277-5200",
            "fax_number": "281-277-7295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NIKITA",
        "middle_name": "MUKESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "R7322",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301112575",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A170065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387124602",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 E Medical Center Dr",
            "address_2": "1st floor Cancer Center",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481095916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.