Individual provider Active NPI

Shahrouz Shadrou, M.D.

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1154534709
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
14655 Issued in NV
Practice address
2820 W Charleston Blvd Ste 33
Las Vegas, NV 89102-1934
Phone
(702) 880-1558
Fax
(702) 870-6821
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT189457 PA
Hospitalist Physician 208M00000X MD438178 PA
Nephrology Physician 207RN0300X 14655 NV Primary

Addresses

Primary practice location

2820 W Charleston Blvd Ste 33
Las Vegas, NV 89102-1934

Mailing address

2820 W Charleston Blvd Ste 33
Las Vegas, NV 89102-1934
Phone (702) 880-1558

Other practice location 1

2810 W Charleston Blvd
Suite E-47
Las Vegas, NV 89102-1921
Phone (702) 880-1558

Other practice location 2

2810 W Charleston Blvd
Suite E-47
Las Vegas, NV 89102-1921
Phone (702) 880-1558

Other identifiers 1

IdentifierTypeStateIssuer
1154534709MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20130306000080 NV Practitioner - Nephrology 3678728284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Qazi Makhija and Barney LLPGroup PAC ID 5092717702, 12 clinicians

Practice addresses (Care Compare)

2820 W Charleston Blvd
Suite 33
Las Vegas, NV 89102-1934
Phone (702) 880-1558

Hospital & facility affiliations

  • DaVita Cheyenne Dialysis Dialysis facility, Las Vegas, NV, CCN 292548
  • DaVita Southern Hills Dialysis Center Dialysis facility, Las Vegas, NV, CCN 292521
  • Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057
  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT189457PAMDInternal Medicine Physician
MD438178PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qazi Makhija & Barney LLP Nephrology CurrentSince Jan 25, 2013 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

2820 W Charleston Blvd
Ste B33
Las Vegas, NV 89102

2820 W Charleston Blvd
Ste D33
Las Vegas, NV 89102

2810 W Charleston Blvd
Ste E47
Las Vegas, NV 89102
Phone (702) 644-0500

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

4424 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 550-6868

2820 W Charleston Blvd
Ste 33
Las Vegas, NV 89102
Phone (702) 388-4428

Interoperability endpoints

  • Direct secure messaging: shahrouz.shadrou@direct.davitaphysiciansolutions.com

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.

Hospital & facility affiliations 11

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1154534709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD STE 33",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021934",
            "telephone_number": "702-880-1558",
            "fax_number": "702-870-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD STE 33",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021934",
            "telephone_number": "702-880-1558",
            "fax_number": "702-870-6821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 W Charleston Blvd",
            "address_2": "Suite E-47",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021921",
            "country_code": "US",
            "telephone_number": "702-880-1558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2810 W Charleston Blvd",
            "address_2": "Suite E-47",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021921",
            "country_code": "US",
            "telephone_number": "702-880-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADROU",
        "first_name": "SHAHROUZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT189457",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD438178",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "14655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154534709",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.