Individual provider Active NPI

Alireza Shabani-Ardali, MD

  • Hospitalist Physician
  • Corvallis, OR
National Provider Identifier
1083862403
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD173870 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone
(541) 768-5111
NPI assigned
Aug 28, 2008
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD173870 OR
Internal Medicine Physician 207R00000X MD041648 DC
Internal Medicine Physician 207R00000X D76274 MD
Hospitalist Physician 208M00000X MD173870 OR Primary

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-5472

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2906

Other identifiers 2

IdentifierTypeStateIssuer
P01590801OtherORRR MEDICARE (PH&S)-PMG
500690333MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150811006094 OR Practitioner - HospitalistPractitioner - Internal Medicine 4789730508 Reassigns benefits to 12 organizations
I20241226000893 CA Practitioner - Internal Medicine 4789730508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD041648DCMDInternal Medicine Physician
D76274MDMDInternal Medicine Physician
MD173870ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2024 Accepting new patients
Albany General Hospital Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Nov 1, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2024 Accepting new patients
Salem Health CurrentSince Nov 1, 2015 Accepting new patients
Good Shepherd Health Care System CurrentSince Dec 1, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Albany General Hospital CurrentSince Nov 1, 2021 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 20, 2024 Accepting new patients
Salem Health CurrentSince Nov 1, 2015 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2024 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 1, 2021 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 1, 2021 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Nov 1, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 20, 2024 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 1, 2021 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 20, 2024 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Nov 1, 2021 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: ashabaniardali106467@direct.salemhealth.org
  • Direct secure messaging: ashabaniardali216343@samhealth.direct-ci.com

Organizations & group practices 31

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 31

Hospital & facility affiliations 1

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1083862403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-768-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9205 SW Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256603",
            "country_code": "US",
            "telephone_number": "503-216-2906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABANI-ARDALI",
        "first_name": "ALIREZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2024-10-25",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD173870",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD041648",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D76274",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD173870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)-PMG",
            "identifier": "P01590801",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500690333",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.