NPIMap

Individual provider Active NPI

Farshad Raissi Shabari, M.D., M.P.H.

  • Clinical Cardiac Electrophysiology Physician
  • San Diego, CA
National Provider Identifier
1124295027
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
99160 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 543-5743
Fax
(619) 543-2917
NPI assigned
May 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 99160 CA Primary
Cardiovascular Disease Physician 207RC0000X 99160 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 1

IdentifierTypeStateIssuer
W13536MedicaidCA

Other names 1

  • Farshad Raissi Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712002628 CA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9133280183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of California 2,047 clinicians
Imperial Valley Family Care Medical Group a P C 23 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

516 W Aten Rd
Suite 1
Imperial, CA 92251-9805
Phone (760) 355-8300

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • Pioneers Memorial Healthcare District Hospital, Brawley, CA, CCN 050342
  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jun 1, 2016 Accepting new patients
Regents of the University of California Cardiovascular Disease CurrentSince Jun 1, 2016 Accepting new patients
Imperial Valley Family Care Medical Group Apc CurrentSince Sep 1, 2016 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Sep 1, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Memorial Hermann Health System Past Accepting new patients
Ut MD Anderson Cancer Center Past Accepting new patients
Longhorn Emergency Physicians Past Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

516 W Aten Rd
Ste 1
Imperial, CA 92251
Phone (760) 355-7748

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 27

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.

View all 27

Hospital & facility affiliations 3

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": "1210464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1124295027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-5743",
            "fax_number": "619-543-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISSI SHABARI",
        "first_name": "FARSHAD",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-11",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "99160",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "99160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W13536",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARSHAD",
            "last_name": "RAISSI",
            "credential": "MD, MPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.