Shital Pavawalla, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

24673 Issued in CA

Practice address

300 Medical Plaza # B200
Los Angeles, CA 90095-6361

Phone

(310) 794-1195

NPI assigned

Jun 6, 2012

Last updated

Sep 16, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kandm Neuropsychology, a Psychology CorporationGroup PAC ID 8921373184, 11 clinicians

Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score

93.23 of 100Reported as group

Quality

77.83

Promoting interoperability

98

Improvement activities

40

Cost

71.17

Merit-based Incentive Payment System (MIPS)

Final score

89.14 of 100Reported as group

Quality

84.79

Promoting interoperability

99

Improvement activities

40

Cost

73.15

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Medicare reassignment Care Compare group NPD
• K&M Neuropsychology, a Psychology Corporation

  dba California Brain Health Center

  • Clinic/Center
  • Mill Valley, CA
  • NPI 1760900831
  Medicare reassignment Care Compare group NPD
• Terrance W Dushenko, PHD

  • Psychologist
  • Long Beach, CA
  • NPI 1134146871
  Medicare reassignment
• Cedars-Sinai Medical Center

  dba San Vicente Pharmacy

  • Pharmacy
  • Los Angeles, CA
  • NPI 1376514810
  NPD
• Adventist Physician Services, Inc.

  dba Adventist Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Gaithersburg, MD
  • NPI 1376623207
  NPD (past)

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

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Care Compare affiliation
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • West Hollywood, CA
  • NPI 1891940326
  Care Compare affiliation

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1336400357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512717",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510717",
            "telephone_number": "310-967-1780",
            "fax_number": "323-940-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA # B200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956361",
            "telephone_number": "310-794-1195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9909 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208506361",
            "country_code": "US",
            "telephone_number": "240-864-6007",
            "fax_number": "240-864-6125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 Beverly Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-9722",
            "fax_number": "310-248-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVAWALLA",
        "first_name": "SHITAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "24673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.