Individual provider Active NPI

Mahshid Michelle Hamidi, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1174534101
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A63702 Issued in CA
Practice address
5222 Balboa Ave Ste 31
San Diego, CA 92117-6952
Phone
(858) 565-6394
Fax
(858) 565-6471
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A63702 CA Primary

Addresses

Primary practice location

5222 Balboa Ave Ste 31
San Diego, CA 92117-6952

Mailing address

5222 Balboa Ave Ste 31
San Diego, CA 92117-6952
Phone (858) 565-6394

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mahshidhamidi@sdafmg.allscripts.direct.net Direct

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
I20120220000690 CA Practitioner - Family Practice 2264690486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5222 Balboa Ave
Suite 31
San Diego, CA 92117-6952

Hospital & facility affiliations

  • Silver Tree Home Health Inc Home health agency, San Diego, CA, CCN 559731
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63702CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mahshid Michelle Hamidi, a Medical Corporation CurrentSince Dec 21, 2000 Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

5222 Balboa Ave
Ste 31
San Diego, CA 92117
Phone (619) 565-6394

Interoperability endpoints

  • Direct secure messaging: mhamidi24704@sharphealthcare.direct-ci.com

Organizations & group practices 3

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 5

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1174534101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5222 BALBOA AVE STE 31",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176952",
            "telephone_number": "858-565-6394",
            "fax_number": "858-565-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 BALBOA AVE STE 31",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176952",
            "telephone_number": "858-565-6394",
            "fax_number": "858-565-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMIDI",
        "first_name": "MAHSHID",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mahshidhamidi@sdafmg.allscripts.direct.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5222 Balboa Ave Ste 31",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921176952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.