Individual provider Active NPI

Ali P Shahriari, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1407046345
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME116440 Issued in FL
Practice address
3001 NW 49TH Ave
Suite 104
Lauderdale Lakes, FL 33313-7266
Phone
(954) 739-2273
Fax
(954) 739-2742
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01063617A IN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME116440 FL Primary

Addresses

Primary practice location

3001 NW 49TH Ave
Suite 104
Lauderdale Lakes, FL 33313-7266

Mailing address

3001 NW 49TH Ave
Suite 104
Lauderdale Lakes, FL 33313-7266
Phone (954) 739-2273

Other identifiers 1

IdentifierTypeStateIssuer
200877850MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Cardiothoracic Surgeons Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Cardiothoracic Surgeons Pediatrics LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1407046345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 NW 49TH AVE",
            "address_2": "SUITE 104",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137266",
            "telephone_number": "954-739-2273",
            "fax_number": "954-739-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 NW 49TH AVE",
            "address_2": "SUITE 104",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137266",
            "telephone_number": "954-739-2273",
            "fax_number": "954-739-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRIARI",
        "first_name": "ALI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01063617A",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME116440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.