Individual provider Active NPI

Sophie Shirin

  • Dermatology Physician
  • Encino, CA
National Provider Identifier
1114106093
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A66454 Issued in CA
Practice address
16260 Venura Blve Ste 300
Encino, CA 91436
Phone
(818) 905-3880
Fax
(818) 905-7806
NPI assigned
Oct 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A66454 CA Primary

Addresses

Primary practice location

16260 Venura Blve Ste 300
Encino, CA 91436

Mailing address

16260 Venura Blvd Ste 300
Encino, CA 91436
Phone (881) 905-3880

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
I20080103000338 CA Practitioner - Dermatology 3678653672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16260 Ventura Blvd
Suite 300
Encino, CA 91436-4601
Phone (818) 905-3880

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
88.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision50
Removal of skin lesions3017
Removal of skin cancer137
Removal of nail tissue1-10
Skin biopsy716

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66454CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Clinic PA Dermatology PastSince Feb 23, 2020 Accepting new patients

Organizations & group practices 2

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1114106093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 VENURA BLVD STE 300",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "881-905-3880",
            "fax_number": "818-905-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16260 VENURA BLVE STE 300",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-905-3880",
            "fax_number": "818-905-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRIN",
        "first_name": "SOPHIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A66454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.