Michael Shabtai, M.D., Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A91300 Issued in CA

Legal business name

MICHAEL SHABTAI, M.D., INC.

Practice address

17075 Devonshire St
Suite 107
Northridge, CA 91325-1600

Phone

(818) 435-4789

Fax

(818) 363-5454

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael Shabtai, M.D.NPI 1942217021

Title

President / Physician

Phone

(818) 435-4789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Shabtai, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Northridge, CA
  • NPI 1942217021
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250208000000",
    "number": "1265691059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 107",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-435-4789",
            "fax_number": "818-363-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 107",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-435-4789",
            "fax_number": "818-363-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SHABTAI, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2009-08-14",
        "status": "A",
        "authorized_official_last_name": "SHABTAI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT / PHYSICIAN",
        "authorized_official_telephone_number": "818-435-4789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A91300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.