Active NPI
Ami Shah, D.C.
- Chiropractor
- Costa Mesa, CA
National Provider Identifier
1205061801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC31094
- Practice address
- 2755 Bristol St
# 120
Costa Mesa, CA 92626-5985 - Phone
- (949) 631-5050
- Fax
- (949) 631-5052
- NPI assigned
- May 27, 2009
- Last updated
- Aug 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC31094 | CA | Primary |
Addresses
Primary practice location
2755 Bristol St
# 120
Costa Mesa, CA 92626-5985
Mailing address
132 Westport
Newport Beach, CA 92660
Phone (714) 803-1611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110407000342 | CA | Practitioner - Chiropractic | 7719161215 | Practice locations: Costa Mesa, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2755 Bristol St
Suite 120
Costa Mesa, CA 92626-1208
Phone (949) 631-5050
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC31094 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diep Neuro Spine Chiropractic Institute, a Professional Corporation | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Alhambra, CA
- NPI 1245958073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1205061801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 WESTPORT",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "714-803-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2755 BRISTOL ST",
"address_2": "# 120",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265985",
"telephone_number": "949-631-5050",
"fax_number": "949-631-5052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "AMI",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC31094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.