Shaheena Ruby Patierno, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A123688 Issued in CA

Practice address

101 The City Drive South BLDG 1a
Room 1009 RT 128
Orange, CA 92868

Phone

(714) 456-5239

NPI assigned

Mar 31, 2011

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shaheena Ruby Bielman Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbia Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1871551119
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1205125093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE SOUTH BLDG 1A",
            "address_2": "ROOM 1009 RT 128",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE SOUTH BLDG 1A",
            "address_2": "ROOM 1009 RT 128",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIERNO",
        "first_name": "SHAHEENA",
        "middle_name": "RUBY",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A123688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAHEENA",
            "last_name": "BIELMAN",
            "middle_name": "RUBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mayank Shami Pathak, M.D.
• Jody Roben Pathare, NP
• Sameer S. Pathare, M.D.
• Patient First Hospice, Inc.
• Patient First Hospice, Inc.
• Rene Patino, MD
• Patricia Degraw-Schwartz, DDS,Inc (The Tooth Spa)
• Amber Marie Patterson
• Genevieve Patterson
• Mitch Patterson, DC

• Emergency Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.