Pravin Shaw, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A11805 Issued in CA

Practice address

1190 Baker St Ste 100
Costa Mesa, CA 92626-4105

Phone

(714) 668-2500

Fax

(714) 668-2515

NPI assigned

Aug 25, 2011

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newport Urgent Care IncorporatedGroup PAC ID 3375431273, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Newport Urgent Care Incorporated

  • Urgent Care Clinic/Center
  • Newport Beach, CA
  • NPI 1114089513
  Medicare reassignment Care Compare group NPD
• Brea Urgent Care Incorporated

  • Urgent Care Clinic/Center
  • Brea, CA
  • NPI 1639413388
  Medicare reassignment

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1407136187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3699",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926598699",
            "telephone_number": "714-668-2500",
            "fax_number": "714-668-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 BAKER ST STE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264105",
            "telephone_number": "714-668-2500",
            "fax_number": "714-668-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PRAVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Share Our Selves Corporation
• Share Our Selves Corporation
• Share Our Selves Corporation
• Share Our Selves Corporation
• Elham Sharif, MSPO, CPO, CPED
• Shea Optometric Corporation
• Jack Chia Shea, OD
• Deshna Shekar
• Taylor Shelton
• Sue Shepard, MFT

• Family Medicine Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.