NPIMap

Individual provider Active NPI

Shahrukh Mohsin

  • Internal Medicine Physician
  • Colton, CA
National Provider Identifier
1306309273
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
179761 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1000
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X PTL528 CA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 179761 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

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
I20220711001546 CA Practitioner - Internal Medicine 9234519083 Reassigns benefits to 4 organizations
Practice locations: Fontana, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Physicians Hospitalist ServicesGroup PAC ID 5294135612, 14 clinicians

Practice addresses (Care Compare)

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

Hospital & facility affiliations

  • Art of Care Home health agency, Corona, CA, CCN 757817
  • Hospice of Southern California Hospice, Diamond Bar, CA, CCN A11707
  • Unity Hospice Care Inc Hospice, Ontario, CA, CCN A01675
  • Aviva Hospice Inc Hospice, Redlands, CA, CCN B21646
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Montclair Hospital Medical Center Hospital, Montclair, CA, CCN 050758
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • Chino Valley Medical Center Hospital, Chino, CA, CCN 050586
  • Casa Colina Hosp for Rehab Medicine Inpatient rehabilitation facility, Pomona, CA, CCN 05T782
  • Community Extended Care Hospital Of Montclair Nursing home, Montclair, CA, CCN 056444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179761CAMDInternal Medicine Physician
PTL528CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Inland Physicians Primary Care Services Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Inland Physicians Hospitalist Services Hospitalist CurrentSince Sep 1, 2022 Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

9525 Monte Vista Ave
Unit 105
Montclair, CA 91763
Phone (909) 626-1205

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

Interoperability endpoints

  • Direct secure messaging: s.mohsin@ipmg.directbygreenway.com
  • Direct secure messaging: casacolina@direct.casacolina.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of Southern CaliforniaDiamond Bar, CA, CCN A11707 Hospice Contracted Managing Employee Apr 5, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 11

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1306309273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSIN",
        "first_name": "SHAHRUKH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "PTL528",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "179761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.