NPIMap

Individual provider Active NPI

Reyzan E Shali, MD

  • Internal Medicine Physician
  • Carlsbad, CA
National Provider Identifier
1245245018
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76230 Issued in CA
Practice address
6185 Paseo del Norte Ste 100
Carlsbad, CA 92011-1152
Phone
(760) 940-7000
Fax
(760) 940-0042
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A76230 CA Primary

Addresses

Primary practice location

6185 Paseo del Norte Ste 100
Carlsbad, CA 92011-1152

Mailing address

1926 Via Ctr
Vista, CA 92081-6056
Phone (760) 940-7000

Other practice location 1

1926 Via Ctr
Vista, CA 92081-6056
Phone (760) 940-7000

Other identifiers 1

IdentifierTypeStateIssuer
00A762300MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000582 CA Practitioner - Internal Medicine 1759430887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tri-City Primary Care Medical Group IncGroup PAC ID 3870810823, 8 clinicians

Practice addresses (Care Compare)

6185 Paseo del Norte
Suite 100
Carlsbad, CA 92011-1152
Phone (760) 940-7000

Hospital & facility affiliations

  • Los Robles Healthcare Home health agency, Thousand Oaks, CA, CCN 058059
  • Los Robles Healthcare at Home Home health agency, San Diego, CA, CCN 053100
  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Advantage Health Systems Home health agency, San Diego, CA, CCN 058355
  • Lorian Health Home health agency, San Diego, CA, CCN 058113
  • Paramount Hospice Hospice, San Diego, CA, CCN 751786
  • Los Robles Healthcare SD Hospice, San Diego, CA, CCN B21634
  • Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128
  • Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
  • Bayshire Carlsbad Nursing home, Carlsbad, CA, CCN 555745
  • Carlsbad by the Sea Nursing home, Carlsbad, CA, CCN 056496
  • Vista Knoll Specialized Care Facility Nursing home, Vista, CA, CCN 555425

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Primary Care Medical Group, Inc CurrentSince Nov 2, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine CurrentSince Mar 16, 2009 Accepting new patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health CurrentSince Mar 16, 2009 Accepting new patients

Locations

6185 Paseo del Norte
Ste 100
Carlsbad, CA 92011
Phone (714) 272-1600

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

3755 Avocado Blvd
La Mesa, CA 91941
Phone (858) 357-5820

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

1926 Via Ctr
#A
Vista, CA 92081
Phone (760) 940-7000

130 Cedar Rd
#210
Vista, CA 92083
Phone (760) 806-5560

1926 Via Ctr
Vista, CA 92081
Phone (760) 940-7000

130 Cedar Rd
Vista, CA 92083
Phone (760) 806-5400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rshali19234@scrippshlth.medalliesdirect.net
  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f6fa04d-6294-46cb-a755-92fcf4395ad8/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bayshire CarlsbadCarlsbad, CA, CCN 555745 Skilled nursing facility Adp of the SNF Apr 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1245245018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 VIA CTR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816056",
            "telephone_number": "760-940-7000",
            "fax_number": "760-940-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6185 PASEO DEL NORTE STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111152",
            "telephone_number": "760-940-7000",
            "fax_number": "760-940-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1926 Via Ctr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920816056",
            "country_code": "US",
            "telephone_number": "760-940-7000",
            "fax_number": "760-940-0042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALI",
        "first_name": "REYZAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A762300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.