Individual provider Active NPI

Seyed Mohammad Hossein Shafie, MD PHD

  • Neurology Physician
  • Orange, CA
National Provider Identifier
1184806572
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A110364 Issued in CA
Practice address
200 S Manchester Ave
Suite 206
Orange, CA 92868-3217
Phone
(714) 456-7296
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A110364 CA Primary
Vascular Neurology Physician 2084V0102X A110364 CA

Addresses

Primary practice location

200 S Manchester Ave
Suite 206
Orange, CA 92868-3217

Mailing address

8725 E Heatherwood Rd
Anaheim, CA 92808-1690

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
I20160815001342 CA Practitioner - Neurology 5193031078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of Claifornia Univ NeursciencesGroup PAC ID 2769476357, 72 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110364CAMDGeneral Practice Dentistry
A110364CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Claifornia Univ Neursciences Neurology CurrentSince Jun 15, 2016 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

19200 Jamboree Rd
Ste 4200
Irvine, CA 92612

101 The City Dr S
Bldg 30
Orange, CA 92868
Phone (714) 456-6966

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 206
Orange, CA 92868
Phone (714) 456-3420

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 2

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1184806572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 E HEATHERWOOD RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE",
            "address_2": "SUITE 206",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683217",
            "telephone_number": "714-456-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIE",
        "first_name": "SEYED MOHAMMAD",
        "middle_name": "HOSSEIN",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A110364",
            "primary": true
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A110364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.