Mercedeh Modir Shanechi

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A160699 Issued in CA

Practice address

12401 Washington Blvd
Whittier, CA 90602-1006

Phone

(562) 698-0811

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Emergency Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intercommunity Emergency Medical GroupGroup PAC ID 7911892534, 60 clinicians

Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169
• Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393
• Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Intercommunity Emergency Medical Group

  • Emergency Medicine Physician
  • Whittier, CA
  • NPI 1871535286
  Medicare reassignment Care Compare group NPD
• Torrance Health Association Inc

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1083903124
  Medicare reassignment Care Compare group NPD
• Emergency Specialist Physicians Medical Associates, Inc

  • Emergency Medicine Physician
  • Torrance, CA
  • NPI 1518917913
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pih Health Downey Hospital

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1265433551
  Care Compare affiliation
• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  Care Compare affiliation
• Pih Health Whittier Hospital

  • General Acute Care Hospital
  • Whittier, CA
  • NPI 1043215379
  Care Compare affiliation

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1275914350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 VIA MARINA APT 132",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925246",
            "telephone_number": "224-433-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123714",
            "country_code": "US",
            "telephone_number": "312-864-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODIR SHANECHI",
        "first_name": "MERCEDEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2024-10-15",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.066817",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A160699",
            "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": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitra Rouintan DMD, Inc.
• Sanchayeeta Mitra, MD
• Roger Craig Miya, D.D.S.
• Bobby Miyamoto
• Keith S Miyamoto, M.D.
• Gregory John Moegling, D.D.S.
• Nasir A Mohammedi, M.D., M.S., M.S.
• Mohsen Tavoussi, D.O. Professional Corporation
• Veronica Mojica
• Katya Mokfi, OTR/L

• Emergency Medicine Physician in Whittier, CA
• Providers in Whittier, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.