Suzan Shakhshir, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22818 Issued in CA

Practice address

18601 Valley Blvd
Bloomington, CA 92316-1831

Phone

(909) 546-7520

Fax

(909) 877-5468

NPI assigned

Mar 21, 2013

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: suzan.shakhshir@direct.parktreechc.nextgenshare.com
• Direct secure messaging: suzan.shakhshirrnp.p1@direct.plannedparenthoodla.nextgenshare.com

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.

• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bloomington, CA
  • NPI 1952308009
  Medicare reassignment NPD
• Pomona Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pomona, CA
  • NPI 1417211426
  NPD (past)

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1275875759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675822",
            "telephone_number": "909-630-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 VALLEY BLVD",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923161831",
            "telephone_number": "909-546-7520",
            "fax_number": "909-877-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKHSHIR",
        "first_name": "SUZAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fallon Sandoval
• Javier Sandoval Jr., RDN
• Linda Sandoval
• Alexander Sayegh
• Neha Shah
• Dilpreet Singh
• Amy Laurice Smith
• Kathleen Cheyenne Smith, LMFT
• Nicholas Smith
• Social Science Services, Inc.

• Family Nurse Practitioner in Bloomington, CA
• Providers in Bloomington, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.