Individual provider Active NPI

Arta Daryoosh Shirkhodai

  • Internal Medicine Physician
  • Vista, CA
National Provider Identifier
1154985463
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A176820 Issued in CA
Practice address
130 Cedar Rd
Vista, CA 92083-5102
Phone
(760) 806-5820
NPI assigned
Apr 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A176820 CA Primary

Addresses

Primary practice location

130 Cedar Rd
Vista, CA 92083-5102

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 806-5820

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
I20220630002679 CA Practitioner - Internal Medicine 8628458098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

130 Cedar Rd
Vista, CA 92083-5102
Phone (760) 806-5400

Hospital & facility affiliations

  • Advantage Health Systems Home health agency, San Diego, CA, CCN 058355
  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Archer Health Inc Home health agency, Carlsbad, CA, CCN 053124
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176820CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Scripps Health CurrentSince Jul 18, 2022 Accepting new patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

130 Cedar Rd
Ste 220
Vista, CA 92083

130 Cedar Rd
Vista, CA 92083
Phone (760) 806-5400

Organizations & group practices 4

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 4

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1154985463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-806-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CEDAR RD",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835102",
            "telephone_number": "760-806-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRKHODAI",
        "first_name": "ARTA",
        "middle_name": "DARYOOSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A176820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.