NPIMap

Individual provider Active NPI

Shahryar Davari, MD

  • Internal Medicine Physician
  • Downey, CA
National Provider Identifier
1346244373
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76725 Issued in CA
Practice address
11544 Downey Ave
Downey, CA 90241
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0058597 MD
Internal Medicine Physician 207R00000X A76725 CA Primary

Addresses

Primary practice location

11544 Downey Ave
Downey, CA 90241

Mailing address

17595 Harvard St Ste C #1005
Irvine, CA 92614-8522
Phone (240) 305-5279

Other identifiers 1

IdentifierTypeStateIssuer
435002000MedicaidMD

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
I20180827000651 CA Practitioner - Internal Medicine 9133345085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11544 Downey Ave
Downey, CA 90241-4955
Phone (562) 922-2020

1211 W la Palma Ave
Suite 404
Anaheim, CA 92801-2806
Phone (714) 772-8282

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76725CAMDClinical Social Worker
A76725CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shahryar Davari MD PC Internal Medicine CurrentSince Apr 1, 2018 Accepting new patients
Fort Washington Physicians Group Past Accepting new patients
Kaiser Foundation Hospitals Past Accepting new patients
Ravi Passi MD PC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University of California Irvine Past Accepting new patients
Inpatient Specialists PA Internal Medicine Past Accepting new patients

Locations

11544 Downey Ave
Downey, CA 90241
Phone (562) 414-9846

3650 South St
Ste 208
Lakewood, CA 90712
Phone (562) 596-1667

3700 South St
Lakewood, CA 90712
Phone (562) 424-2900

3751 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-3160

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1346244373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17595 HARVARD ST STE C #1005",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148522",
            "telephone_number": "240-305-5279",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11544 DOWNEY AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90241",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVARI",
        "first_name": "SHAHRYAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0058597",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435002000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.