NPIMap

Individual provider Active NPI

Shaun Ehsani, MD

  • Family Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1306040712
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A99065 Issued in CA
Practice address
5333 Hollister Ave Ste 110
Santa Barbara, CA 93111-2379
Phone
(805) 683-0055
Fax
(805) 683-0149
NPI assigned
Jun 12, 2007
Last updated
Aug 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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 A99065 CA Primary

Addresses

Primary practice location

5333 Hollister Ave Ste 110
Santa Barbara, CA 93111-2379

Mailing address

2682 Montrose PL
Santa Barbara, CA 93105-2143
Phone (310) 614-6459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000122 CA Practitioner - Family PracticePractitioner - Internal Medicine 4688746597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson and Engberg Medical CorporationGroup PAC ID 6103970983, 6 clinicians

Practice addresses (Care Compare)

5333 Hollister Ave
Suite 110
Santa Barbara, CA 93111-2379
Phone (805) 682-8844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99065CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Aug 20, 2007 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Aug 20, 2007 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

Interoperability endpoints

  • Direct secure messaging: shaun.ehsani@9985070071812.direct.elationemr.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1306040712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2682 MONTROSE PL",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931052143",
            "telephone_number": "310-614-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 HOLLISTER AVE STE 110",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931112379",
            "telephone_number": "805-683-0055",
            "fax_number": "805-683-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHSANI",
        "first_name": "SHAUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A99065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.