Shahnam Nami Bahrami, M.D.
Individual provider Active NPI Emergency Medicine Physician · Highland, CA
NPI 1184834954 · NPPES record last updated Apr 15, 2024
Key facts
- NPI
- 1184834954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 57669-20 (WI)
- Practice address
- 7237 Cedarwood PL
Highland, CA 92346-5423 - Phone
- (818) 618-9204
- Fax
- (920) 320-5106
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
400 Soldier Creek Dr
Rosebud, SD 57570-8502
Hospital & facility affiliations
- PHS Indian Hospital at Rosebud
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260109000824 | TX | Practitioner - Emergency Medicine | 6305997297 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301088813 | MI | MD | Emergency Medicine Physician |
| 57669-20 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosebud Indian Health Service | Current |
Accepting new patients | |
| Rosebud Indian Health Service | Current |
Accepting new patients | |
| Emergency Medicine Physician Partners of Rancho Mirage, Inc | Emergency Medicine | Past | Accepting new patients |
| Emergency Physicians Medical Group, Inc | Emergency Medicine | Past | Accepting new patients |
| Lakeshore Radiology Associates SC | Past |
Accepting new patients |
Interoperability endpoints
- shahnam.bahrami.1@27998.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 62978 | MN | |
| Emergency Medicine Physician | 207P00000X | 57669-20 | WI | Yes |
| Emergency Medicine Physician | 207P00000X | 4301088813 | MI | |
| Emergency Medicine Physician | 207P00000X | A107510 | CA |
Addresses
Primary practice location
7237 Cedarwood PL
Highland, CA 92346-5423
Mailing address
7237 Cedarwood PL
Highland, CA 92346-5423
Phone (818) 618-9204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57669 | Other | WI | LICENSE |
Other providers in Highland, CA
- Assured Hospice
- Sheena Ataian
- Thaung Myat Aung
- Naveh Mary Ayon
- Redentor Bacani
- Gavrielle Concepcion Balibay
- Neida Barco
- Thomas Battaile Jr.
- Jenna Raelene Baumann
- Beaver Medical Group LP
All providers in Highland, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.