Individual provider Active NPI

Shahrzad Sodagar-Marvasti, M.D.

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1275748733
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A42473 Issued in CA
Practice address
7140 Indiana Ave
Riverside, CA 92504-4544
Phone
(951) 358-6000
Fax
(951) 358-6044
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A42473 CA Primary

Addresses

Primary practice location

7140 Indiana Ave
Riverside, CA 92504-4544

Mailing address

PO Box 7849
Riverside, CA 92513-7849
Phone (951) 358-5222

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031230000417 CA Practitioner - Family Practice 4082512983 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42473CAMDDentist
A42473CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Nov 26, 2014 Accepting new patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Nov 26, 2014 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

4065 County Circle Dr
Rm 403
Riverside, CA 92503

7140 Indiana Ave
Riverside, CA 92504
Phone (909) 358-6035

Interoperability endpoints

  • Direct secure messaging: ssodagarmarvasti96844@direct.llu.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275748733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7849",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137849",
            "telephone_number": "951-358-5222",
            "fax_number": "951-358-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044544",
            "telephone_number": "951-358-6000",
            "fax_number": "951-358-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODAGAR-MARVASTI",
        "first_name": "SHAHRZAD",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.