Shafeeq S Shamsid-Deen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G36419 Issued in CA

Practice address

5970 S Central Ave
Los Angeles, CA 90001

Phone

(323) 234-3280

Fax

(323) 234-3493

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Marna Health Services, Inc.

  • Long Term Care Hospital
  • San Bernardino, CA
  • NPI 1811306277

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235283094
  Medicare reassignment
• Pasadena Hospital Association, LTD.

  • Psychiatric Hospital Unit
  • Pasadena, CA
  • NPI 1437121142
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• Usc Arcadia Hospital

  • Rehabilitation Hospital Unit
  • Arcadia, CA
  • NPI 1164410593
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1275646952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAN GABRIEL BLVD STE 200",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917704394",
            "telephone_number": "877-358-5841",
            "fax_number": "323-248-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-234-3280",
            "fax_number": "323-234-3493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 N Azusa Ave",
            "address_purpose": "LOCATION",
            "city": "Azusa",
            "state": "CA",
            "postal_code": "917023521",
            "country_code": "US",
            "telephone_number": "626-969-7885",
            "fax_number": "626-969-9686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMSID-DEEN",
        "first_name": "SHAFEEQ",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G36419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "952662606",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G36419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jahangir Shams-Zaffarghandi, PHARM.D
• Nikita Shams
• Kamran Shamsa, M.D.
• Nora G. Shamsi
• Rasheedah Shamsid-Deen
• Masoud Shamszadeh, MD
• Sanam Shamtobi
• Jacqueline Shamtoob, PH.D.
• Deborah Shamtoub, RBT
• Shervin Shamtoub, D.P.M.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.