Shibani Sunilkumar Shah

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95018730 Issued in CA

Practice address

1441 Avocado Ave Ste 409
Newport Beach, CA 92660-7705

Phone

(949) 640-4501

Fax

(949) 640-0741

NPI assigned

Sep 22, 2021

Last updated

Oct 11, 2021By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Island Dermatology, Inc.Group PAC ID 1850395070, 27 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.33 of 100Reported as group

Quality

93.33

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

85.17 of 100Reported as group

Quality

74.51

Promoting interoperability

92

Improvement activities

40

Cost

82.72

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00155

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.

• Island Dermatology, Inc

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1508815556
  Medicare reassignment Care Compare group NPD
• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804
  Medicare reassignment NPD
• Huntington Dermatology Medical Group Inc

  dba Dynasty Dermatology

  • Dermatology Physician
  • Pasadena, CA
  • NPI 1275664435
  Medicare reassignment NPD
• J Robert West, M.D., Inc

  dba Southern California Dermatology

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  Medicare reassignment NPD
• David B. Friedman, MD, Inc

  • Procedural Dermatology Physician
  • Anaheim, CA
  • NPI 1164620795
  NPD
• Hai Tran, M.D., Inc.

  • Dermatology Physician
  • Victorville, CA
  • NPI 1639366966
  NPD
• Cary Edward Feibleman MD Inc

  • Dermatology Physician
  • Long Beach, CA
  • NPI 1982796389
  NPD (past)
• Lorrie J Klein MD Apc

  • Dermatology Physician
  • Laguna Niguel, CA
  • NPI 1083631808
  NPD (past)

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1326719063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 SAN IGNACIO AVE STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191215",
            "telephone_number": "714-312-9701",
            "fax_number": "408-904-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE STE 409",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607705",
            "telephone_number": "949-640-4501",
            "fax_number": "949-640-0741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E 28th St Ste 311",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062780",
            "country_code": "US",
            "telephone_number": "562-595-4777",
            "fax_number": "562-424-9644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 W 6th St Ste 370",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907323527",
            "country_code": "US",
            "telephone_number": "310-519-8890",
            "fax_number": "310-519-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHIBANI",
        "middle_name": "SUNILKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018730",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95063243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Anne Shah, FNP
• Meera Shah
• Pravin Shah, MD
• Samina Shah, DIETITIAN
• Sarah Shah
• Usman S Shah, MD
• Vraj Shah
• Pardis Shahamat
• Michael S. Shahbazian, M.D.
• Saja Shaheen Gleeson, MD

• Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.