Individual provider Active NPI

Reza Shirazi, M.D.

  • Radiation Oncology Physician
  • San Diego, CA
National Provider Identifier
1336175272
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A95800 Issued in CA
Practice address
3366 5TH Ave
San Diego, CA 92103-5713
Phone
(619) 230-0400
Fax
(858) 429-7936
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A95800 CA
Radiation Oncology Physician 2085R0001X A95800 CA Primary

Addresses

Primary practice location

3366 5TH Ave
San Diego, CA 92103-5713

Mailing address

PO Box 33865
San Diego, CA 92163-3865
Phone (858) 888-7700

Other identifiers 4

IdentifierTypeStateIssuer
11621447OtherCACAQH ID
00A958000MedicaidCA
A95800OtherCASTATE LICENSE
87929OtherOHOHIO STATE LICENSE

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
I20060821000549 CA Practitioner - Radiation Oncology 2668475245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

5395 Ruffin Rd
Suite 103
San Diego, CA 92123-1338
Phone (858) 505-4100

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95800CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Radiosurgery Center, a Medical Corporation Radiation Oncology CurrentSince Feb 27, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Genesis Healthcare Partners PC Specialist CurrentSince Apr 1, 2011 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Palomar Health Past Accepting new patients
Scripps Health Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Regents of the University of California Past Accepting new patients
Radiation Medical Group Inc Specialist Past Accepting new patients
Scripps Health Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Scripps Clinic Medical Group, Inc Past Accepting new patients
The Radiation Medical Group Inc Specialist Past Accepting new patients
Genesis Healthcare Partners, PC PastSince Jan 12, 2025 Accepting new patients

Locations

701 E Grand Ave
Ste 200
Escondido, CA 92025
Phone (760) 839-7370

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

1605 Avocado Ave
Newport Beach, CA 92660
Phone (949) 760-3025

3366 5th Ave
San Diego, CA 92103
Phone (619) 230-0400

5395 Ruffin Rd
Ste 103
San Diego, CA 92123
Phone (858) 505-4100

3366 5th Ave
Ste 103
San Diego, CA 92103

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rezashirazi@ghp.allscriptsdirect.net
  • Direct secure messaging: rshirazi81607@scrippshlth.medalliesdirect.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1336175272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33865",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633865",
            "telephone_number": "858-888-7700",
            "fax_number": "858-888-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035713",
            "telephone_number": "619-230-0400",
            "fax_number": "858-429-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "REZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A95800",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A95800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11621447",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A958000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A95800",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE LICENSE",
            "identifier": "87929",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.