Organization Active NPI

Shawn Zardouz M.D. Inc

  • Interventional Pain Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1083285175
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
SHAWN ZARDOUZ M.D. INC
Practice address
520 Superior Ave Ste 205
Newport Beach, CA 92663-3667
Phone
(949) 232-1019
NPI assigned
Jul 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Dr. Shawn Zardouz, MDNPI 1538504733
Title
President
Phone
(313) 407-9530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary
Pain Clinic/Center 261QP3300X

Addresses

Primary practice location

520 Superior Ave Ste 205
Newport Beach, CA 92663-3667

Mailing address

PO Box 1133
Costa Mesa, CA 92628-1133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210823002521 CA Part B Supplier - Clinic/Group Practice 6608271069 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

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": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1083285175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1133",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926281133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 205",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633667",
            "telephone_number": "949-232-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN ZARDOUZ M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "ZARDOUZ",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-407-9530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.