Individual provider Active NPI

Natan Ryan Shaoulian, M.D.

  • Neurology Physician
  • Beverly Hills, CA
National Provider Identifier
1114926433
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A72440 Issued in CA
Practice address
9301 Wilshire Blvd
Suite 600
Beverly Hills, CA 90210-5424
Phone
(310) 278-2525
Fax
(310) 278-2525
NPI assigned
Jul 19, 2005
Reactivated
Sep 28, 2006
Last updated
Sep 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A72440 CA Primary

Addresses

Primary practice location

9301 Wilshire Blvd
Suite 600
Beverly Hills, CA 90210-5424

Mailing address

503 N Rexford Dr
Beverly Hills, CA 90210-3309
Phone (310) 278-2525

Other identifiers 1

IdentifierTypeStateIssuer
00A724400MedicaidCA

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
I20040519001093 CA Practitioner - Neurology 9931190964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Loyola University of Chicago, Stritch School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4408 Sepulveda Blvd
Culver City, CA 90230-4801
Phone (310) 278-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as individual
Quality
65.5
Promoting interoperability
83
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nerve MD, Inc. Neurology CurrentSince Aug 18, 2009 Accepting new patients
Usc Neurologists, Inc. Past Accepting new patients

Locations

9301 Wilshire Blvd
Ste 600
Beverly Hills, CA 90210
Phone (310) 278-2525

4408 Sepulveda Blvd
Culver City, CA 90230
Phone (310) 278-2525

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1114926433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N REXFORD DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103309",
            "telephone_number": "310-278-2525",
            "fax_number": "310-278-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 WILSHIRE BLVD",
            "address_2": "SUITE 600",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105424",
            "telephone_number": "310-278-2525",
            "fax_number": "310-278-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAOULIAN",
        "first_name": "NATAN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-09-23",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A72440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A724400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.