NPIMap

Individual provider Active NPI

Reza Shahbaz, M.D.

  • Vascular & Interventional Radiology Physician
  • Orange, CA
National Provider Identifier
1124349980
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A106268 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-9870
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X A106268 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

101 City Drive
Orange, CA 92868
Phone (714) 456-7891

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
I20130610000346 CA Practitioner - Diagnostic Radiology 5496994105 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Imaging and Intervention IncGroup PAC ID 4486178332, 9 clinicians
Reza Shahbaz MD IncGroup PAC ID 6800209180, 10 clinicians
KND Development 59 LLCGroup PAC ID 3678602802, 176 clinicians

Practice addresses (Care Compare)

17772 Beach Blvd
Huntington Beach, CA 92647-6819
Phone (714) 843-5000

2601 E Chapman Ave
Orange, CA 92869-3206
Phone (949) 800-9744

550 N Monterey Ave
Ontario, CA 91764-3318
Phone (909) 391-0333

Hospital & facility affiliations

  • Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226
  • Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
  • Foothill Regional Medical Center Hospital, Tustin, CA, CCN 050780
  • Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230
  • West Anaheim Medical Center Hospital, Anaheim, CA, CCN 050426
  • Kindred Hospital Brea Long-term care hospital, Brea, CA, CCN 052039

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106268CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Imaging and Intervention Inc Vascular & Interventional Radiology CurrentSince Mar 11, 2025 Accepting new patients
Reza Shahbaz MD Inc CurrentSince Oct 25, 2020 Accepting new patients
KND Development 59, LLC CurrentSince May 1, 2020 Accepting new patients
John P Anderson MD Russell M Perry MD and Mark a Sharzer MD a Med CRP CurrentSince Apr 22, 2013 Accepting new patients
KND Development 59 LLC Current Accepting new patients
KND Development 59, LLC CurrentSince May 1, 2020 Accepting new patients
KND Development 59, LLC Past Accepting new patients
KND Development 59 LLC Past Accepting new patients
KND Development 59 LLC Past Accepting new patients
KND Development 59 LLC Past Accepting new patients

Locations

1111 W La Palma Ave
Anaheim, CA 92801
Phone (714) 774-1450

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

17772 Beach Blvd
Huntington Beach, CA 92647
Phone (714) 842-1473

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

5525 W Slauson Ave
Los Angeles, CA 90056
Phone (310) 642-0325

550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

2224 Medical Center Dr
Perris, CA 92571
Phone (951) 436-3460

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

1901 College Ave
Santa Ana, CA 92706
Phone (714) 564-7800

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 and National Provider Directory roles.

View all 31

Hospital & facility affiliations 8

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1124349980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CITY DRIVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBAZ",
        "first_name": "REZA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A106268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.