Individual provider Active NPI

Nasim Shahbazi, MD

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1356933683
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
168647 Issued in CA
Practice address
11100 Warner Ave Ste 218
Fountain Valley, CA 92708-7511
Phone
(714) 641-9696
Fax
(714) 641-1211
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 168647 CA Primary

Addresses

Primary practice location

11100 Warner Ave Ste 218
Fountain Valley, CA 92708-7511

Mailing address

9373 Hazard Way Ste 200
Ste 200
San Diego, CA 92123-1226
Phone (858) 810-8000

Other practice location 1

2205 Ross Ave Ste 101
El Centro, CA 92243-3623
Phone (760) 353-0404

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
I20210413002966 CA Practitioner - Nephrology 5597173484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balboa Nephrology Medical Group IncGroup PAC ID 9638164015, 78 clinicians

Practice addresses (Care Compare)

11100 Warner Ave
Suite 218
Fountain Valley, CA 92708-7511
Phone (714) 641-9696

725 W la Veta Ave
Suite 100
Orange, CA 92868-4445
Phone (714) 641-9696

Hospital & facility affiliations

  • DaVita Garden Grove Harbor Dialysis Dialysis facility, Garden Grove, CA, CCN 552781
  • DaVita Huntington Beach Dialysis Dialysis facility, Huntington Beach, CA, CCN 052641
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Hoag Orthopedic Institute Hospital, Irvine, CA, CCN 050769
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168647CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Balboa Nephrology Medical Group, Inc. Nephrology CurrentSince May 1, 2021 Accepting new patients
Balboa Nephrology Medical Group,Inc. CurrentSince May 1, 2021 Accepting new patients
Pioneers Memorial Healthcare District Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients

Locations

737 W Hobsonway
Blythe, CA 92225
Phone (760) 922-4415

2205 Ross Ave
El Centro, CA 92243
Phone (760) 353-0404

2205 Ross Ave
Ste 101
El Centro, CA 92243
Phone (760) 353-0404

11100 Warner Ave
Ste 218
Fountain Vly, CA 92708
Phone (714) 424-0290

4225 Executive Sq
Ste 450
La Jolla, CA 92037
Phone (858) 810-8000

3300 Vista Way
Ste B
Oceanside, CA 92056
Phone (760) 967-9569

725 W La Veta Ave
Ste 110
Orange, CA 92868
Phone (714) 538-7060

725 W La Veta Ave
Orange, CA 92868
Phone (714) 737-8453

4060 4th Ave
Ste 220
San Diego, CA 92103
Phone (619) 299-2350

9373 Hazard Way
Ste 200
San Diego, CA 92123
Phone (858) 810-8000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: nshahbazi843780@direct.memorialcare.org
  • Direct secure messaging: nshahbazi33723@direct.acumenmd.com

Organizations & group practices 4

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 8

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": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1356933683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9373 HAZARD WAY STE 200",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231226",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 218",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087511",
            "telephone_number": "714-641-9696",
            "fax_number": "714-641-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Ross Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922433623",
            "country_code": "US",
            "telephone_number": "760-353-0404",
            "fax_number": "760-353-0392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHBAZI",
        "first_name": "NASIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "168647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.