Individual provider Active NPI

Shrey Kanjiya, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Los Angeles, CA
National Provider Identifier
1104212083
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
A168099 Issued in CA
Practice address
6801 Park Ter # 140
Los Angeles, CA 90045-1543
Phone
(310) 665-7200
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A168099 CA
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A168099 CA Primary

Addresses

Primary practice location

6801 Park Ter # 140
Los Angeles, CA 90045-1543

Mailing address

Stony Brook Univ Med Center Department of
HSC T-18
Stony Brook, NY 11794-8181
Phone (631) 444-1487

Other practice location 1

Stony Brook Univ Med Center Department Of
HSC T-18
Stony Brook, NY 11794-8181
Phone (631) 444-1487

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
I20200731002664 CA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2062837453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Vermont College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Domenick J Sisto M D IncGroup PAC ID 0648230292, 10 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 615
Sherman Oaks, CA 91403-1839
Phone 8189052222205

Hospital & facility affiliations

  • Americare Home Health, Inc Home health agency, Van Nuys, CA, CCN 059594
  • Valley Hills Home Health Care, Inc Home health agency, Encino, CA, CCN 059741
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116
  • Sherman Oaks Hospital Hospital, Sherman Oaks, CA, CCN 050755
  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Merit-based Incentive Payment System (MIPS)

Final score
86.93 of 100Reported as group
Quality
83.47
Improvement activities
40
Cost
61.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement18
Knee replacement18
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168099CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Domenick J Sisto M D Inc CurrentSince Aug 16, 2021 Accepting new patients

Locations

38660 Medical Center Dr
Ste A250
Palmdale, CA 93551
Phone (661) 267-7777

21064 Centre Pointe Pkwy
Santa Clarita, CA 91350

4955 Van Nuys Blvd
Ste 615
Sherman Oaks, CA 91403
Phone (818) 905-2222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJEEDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJEEDD/Endpoint/GJEEDD
  • Direct secure messaging: skanjiya@laoi1795.srs-direct.com

Organizations & group practices 1

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 5

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1104212083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIV MED CENTER DEPARTMENT OF",
            "address_2": "HSC T-18",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948181",
            "telephone_number": "631-444-1487",
            "fax_number": "631-444-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER # 140",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-665-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook Univ Med Center Department Of",
            "address_2": "HSC T-18",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948181",
            "country_code": "US",
            "telephone_number": "631-444-1487",
            "fax_number": "631-444-3502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANJIYA",
        "first_name": "SHREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A168099",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A168099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.