Individual provider Active NPI

Shavash Safvati, MD

  • General Practice Physician
  • North Hollywood, CA
National Provider Identifier
1083704076
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A49842 Issued in CA
Practice address
12626 Riverside Dr
Suite #303
North Hollywood, CA 91607
Phone
(818) 760-2434
Fax
(818) 760-8832
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A49842 CA Primary

Addresses

Primary practice location

12626 Riverside Dr
Suite #303
North Hollywood, CA 91607

Mailing address

12626 Riverside Dr
Suite #303
North Hollywood, CA 91607
Phone (818) 760-2434

Other identifiers 1

IdentifierTypeStateIssuer
00A498420MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000496 CA Practitioner - Internal Medicine 3870554736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12626 Riverside Dr
Suite 303
North Hollywood, CA 91607-3476
Phone (818) 760-2434

12626 Riverside Dr
Suite 303
North Hollywood, CA 91607-3484

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A49842CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shavash Safvati M D Inc CurrentSince May 26, 2010 Accepting new patients
Regal Medical Group, Inc. General Practice Past Accepting new patients
Dignity Community Care Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients

Locations

12626 Riverside Dr
Ste 303
Valley Village, CA 91607
Phone (424) 209-7787

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: shavashsafvati.160.5253@securemailmdscloud.mdsynergy.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1083704076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #303",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "818-760-2434",
            "fax_number": "818-760-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #303",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "818-760-2434",
            "fax_number": "818-760-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFVATI",
        "first_name": "SHAVASH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A49842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A498420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.