Individual provider Active NPI

Mohammed Shaker, MD, PHD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1356754386
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
149175 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 543-6222
NPI assigned
Jun 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 149175 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
San Diego, CA 92103-9000

Other practice location 1

1250 Bay Ridge Pkwy # 2F
Brooklyn, NY 11228-2402
Phone (912) 631-5100

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
I20171026002910 CA Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Hospitalist 0941503981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

15004 Innovation Dr
San Diego, CA 92128-3498
Phone (858) 487-1800

Hospital & facility affiliations

  • Archer Health Inc Home health agency, Carlsbad, CA, CCN 053124
  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149175CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Diego CurrentSince Aug 29, 2017 Accepting new patients
Scripps Health Internal Medicine Current Accepting new patients
County of San Diego CurrentSince Aug 29, 2017 Accepting new patients
Scripps Health Inpatient Providers Medical Group Inc. CurrentSince Nov 1, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Jul 1, 2018 Accepting new patients
Scripps Health Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

15004 Innovation Dr
San Diego, CA 92128
Phone (858) 487-1800

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

Interoperability endpoints

  • Direct secure messaging: mshaker79497@scrippshlth.medalliesdirect.net

Organizations & group practices 10

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 5

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": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356754386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Bay Ridge Pkwy # 2F",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112282402",
            "country_code": "US",
            "telephone_number": "912-631-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKER",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "149175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.