Individual provider Active NPI

Shannon Marisa Navarro, MD, MPH

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1174883052
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A126458 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033-5313
Phone
(323) 442-8541
Fax
(323) 442-8755
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A126458 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Other practice location 1

1200 N State St
D&T 3D321
Los Angeles, CA 90033-1029
Phone (323) 409-7257

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
I20170601002016 CA Practitioner - Diagnostic Radiology 1658651518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Southern California Keck School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

10850 White Rock Rd
Rancho Cordova, CA 95670-6044

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

2660 W Covell Blvd
Davis, CA 95616-5645
Phone (530) 747-3000

3200 Bell Rd
Auburn, CA 95603-9244
Phone (530) 885-7616

3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone (916) 851-1440

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

4868 X St
Sacramento, CA 95817-2205

550 W Ranch View Dr
Suite 1200
Rocklin, CA 95765-5398
Phone (916) 295-5810

7551 Madison Ave
Citrus Heights, CA 95610-7449
Phone (916) 904-3000

8110 Laguna Blvd
Elk Grove, CA 95758-8094
Phone (916) 683-3942

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
126458CAMDClinical Social Worker
A126458CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Diagnostic Radiology CurrentSince Aug 22, 2018 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Lac Usc Keck School of Medicine Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

3850 G St
Merced, CA 95340
Phone (209) 384-6528

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

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 1

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174883052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "D&T 3D321",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-409-7257",
            "fax_number": "323-441-8233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAVARRO",
        "first_name": "SHANNON",
        "middle_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A126458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.