Mohammad A Shadjari, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

CA17775 Issued in CA

Practice address

1635 E Ocean Blvd
Apt. F3
Long Beach, CA 90802-6001

Phone

(818) 599-6944

NPI assigned

Jan 3, 2008

Sex

Male

Sole proprietor

Yes

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mohammad.shadjari.p1@direct.scfhc.nextgenshare.com

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1396920864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E OCEAN BLVD",
            "address_2": "APT. F3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026001",
            "telephone_number": "818-599-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E OCEAN BLVD",
            "address_2": "APT. F3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026001",
            "telephone_number": "818-599-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADJARI",
        "first_name": "MOHAMMAD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "CA17775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Youssef Shaban, DO
• Shaheh Shabanian, LCSW128329
• Luke Shackelford
• Keymia Japerell Shade
• Jacquelyn Shader
• Jeremy Richard Shadrick
• Penny Sue Shafer, R.PH.
• Seth Shaffer, M.A.
• Yvonne Shaffer, RASI
• Anoop Shah, MD

• Medical Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.