Individual provider Active NPI

Samik Shah

  • Gastroenterology Physician
  • Valencia, CA
National Provider Identifier
1346696333
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A176785 Issued in CA
Practice address
25775 McBean Pkwy Ste 214
Valencia, CA 91355-3703
Phone
(661) 255-2420
Fax
(661) 753-0552
NPI assigned
May 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A176785 CA Primary

Addresses

Primary practice location

25775 McBean Pkwy Ste 214
Valencia, CA 91355-3703

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

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
I20220803002953 CA Practitioner - Gastroenterology 4385934470 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Rutgers New Jersey Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, shared by 11 NPIs, 1,426 clinicians

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

25775 McBean Pkwy
Suite 108
Valencia, CA 91355-3702
Phone (661) 255-8252

25775 W McBean Pkwy
Suite 115
Valencia, CA 91355-3702
Phone (661) 255-2420

Hospital & facility affiliations

  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy69
Upper gastrointestinal (GI) endoscopy for acid reflux115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176785CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Gastroenterology CurrentSince Sep 1, 2022 Accepting new patients
The Regents of the University of California CurrentSince Dec 1, 2024 Accepting new patients
The Regents of the University of California CurrentSince Mar 19, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients
Gastrointestinal Medical Center ASC Gastroenterology Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

4343 Lankershim Blvd
Ste 210
North Hollywood, CA 91602
Phone (818) 843-9038

892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 100
Thousand Oaks, CA 91360
Phone (805) 418-3444

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

27235 Tourney Rd
Ste 1100
Valencia, CA 91355
Phone (661) 254-8032

25775 McBean Pkwy
Ste 115
Valencia, CA 91355
Phone (661) 255-2420

25775 McBean Pkwy
Ste 214
Valencia, CA 91355
Phone (661) 255-2420

7320 Woodlake Ave
Ste 320
West Hills, CA 91307
Phone (818) 436-7686

Organizations & group practices 7

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 3

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1346696333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 MCBEAN PKWY STE 214",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553703",
            "telephone_number": "661-255-2420",
            "fax_number": "661-753-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A176785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.