Individual provider Active NPI

Ameerah Ann-Shaban Shalikar, M.D.

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1275911315
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A151302 Issued in CA
Practice address
1770 N Orange Grove Ave
Suite 101
Pomona, CA 91767-3027
Phone
(909) 469-9494
Fax
(909) 620-7285
NPI assigned
May 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A151302 CA Primary

Addresses

Primary practice location

1770 N Orange Grove Ave
Suite 101
Pomona, CA 91767-3027

Mailing address

1770 N Orange Grove Ave
Suite 101
Pomona, CA 91767-3027
Phone (909) 469-9494

Other names 1

  • Ameerah Shaban Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20190712000691 CA Practitioner - Family Practice 0042583536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Family Medicine ClinicGroup PAC ID 7719330539, 3 clinicians

Practice addresses (Care Compare)

1330 W Covina Blvd
Suite 201
San Dimas, CA 91773-3200
Phone (626) 999-9118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151302CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Medical Group, Inc. Family Medicine CurrentSince Jul 28, 2023 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Jul 28, 2023 Accepting new patients
Desert Valley Medical Group, Inc. Current Accepting new patients
Advocate Family Medicine Clinic Family Medicine CurrentSince Dec 11, 2023 Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients

Locations

5450 Jefferson Ave
Ste 3
Chino, CA 91710
Phone (909) 464-8600

1330 W Covina Blvd
Ste 201
San Dimas, CA 91773
Phone (626) 999-9118

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ameerah.shalikar.p1@direct.dvmg.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1275911315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE",
            "address_2": "SUITE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-620-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE",
            "address_2": "SUITE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-620-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALIKAR",
        "first_name": "AMEERAH",
        "middle_name": "ANN-SHABAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A151302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMEERAH",
            "last_name": "SHABAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.