Individual provider Active NPI

Shawn Michael Roofian, MD

  • Pain Medicine (Anesthesiology) Physician
  • Los Angeles, CA
National Provider Identifier
1164654380
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A113626 Issued in CA
Practice address
1500 San Pablo St
4TH Floor
Los Angeles, CA 90033-5313
Phone
(323) 442-7400
NPI assigned
Aug 20, 2009
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A113626 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X A113626 CA Primary

Addresses

Primary practice location

1500 San Pablo St
4TH Floor
Los Angeles, CA 90033-5313

Mailing address

PO Box 3129
Torrance, CA 90510-3129
Phone (310) 792-3914

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
I20140620000219 CA Practitioner - Pain ManagementPractitioner - Anesthesiology 8426272139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8500 Wilshire Blvd
Suite 105
Beverly Hills, CA 90211-3110
Phone (310) 926-4922

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113626CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn Roofian MD Inc Pain Medicine CurrentSince Jun 15, 2017 Accepting new patients
Pih Health Physicians Anesthesiology CurrentSince Aug 20, 2017 Accepting new patients
R & R Surgical Centers Current Accepting new patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Aug 20, 2017 Accepting new patients
Precision Occupational Medical Group, Inc. Past Accepting new patients

Locations

8500 Wilshire Blvd
Ste 105
Beverly Hills, CA 90211
Phone (310) 926-4922

310 Third Ave
Ste B5
Chula Vista, CA 91910
Phone (310) 926-4922

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

19228 Ventura Blvd
Ste A
Tarzana, CA 91356
Phone (818) 225-0045

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1164654380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "address_2": "4TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOFIAN",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A113626",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A113626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.