NPIMap

Individual provider Active NPI

Shahnawaz Ansari, MD

  • Diagnostic Radiology Physician
  • San Bernardino, CA
National Provider Identifier
1417324633
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
PERMIT Issued in NJ
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 883-8711
NPI assigned
Aug 24, 2015
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X PERMIT NJ Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

7102 Stockyard
Riverside, CA 92507-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200323001530 CA Practitioner - Diagnostic Radiology 9931537131 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Riverside, CA 92501
Phone (951) 788-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PERMITNJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology Medical Group Inc Diagnostic Radiology CurrentSince Aug 8, 2025 Accepting new patients
Pinnacle Medical Group, Inc CurrentSince Jun 22, 2021 Accepting new patients
Adventist Health Clearlake Hospital Inc. CurrentSince Jul 29, 2023 Accepting new patients
Golden State Imaging Associates Inc Diagnostic Radiology CurrentSince May 28, 2022 Accepting new patients
Ukiah Adventist Hospital Diagnostic Radiology CurrentSince Mar 1, 2023 Accepting new patients
Reedley Community Hospital CurrentSince Nov 1, 2022 Accepting new patients
Willits Hospital Inc. CurrentSince Mar 1, 2023 Accepting new patients
Pinnacle Medical Group, Inc CurrentSince Jun 22, 2021 Accepting new patients
Universal Radiology Partners of California PC Diagnostic Radiology CurrentSince Mar 12, 2024 Accepting new patients
Hanford Community Hospital CurrentSince Nov 1, 2022 Accepting new patients
Ukiah Adventist Hospital CurrentSince Mar 1, 2023 Accepting new patients
Adventist Health Tulare CurrentSince Nov 1, 2022 Accepting new patients
Reedley Community Hospital CurrentSince Nov 1, 2022 Accepting new patients
Hanford Medical Associates, Inc. Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients
Dignity Health Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

17100 Euclid St
Ste 4004
Fountain Vly, CA 92708
Phone (714) 966-7200

125 Mall Dr
Ste 305
Hanford, CA 93230
Phone (559) 537-0440

47111 Monroe St
#1112
Indio, CA 92201

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

10431 Lemon Ave
Ste N
Rch Cucamonga, CA 91737
Phone (909) 466-6579

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4500 Brockton Ave
Ste 219
Riverside, CA 92501
Phone (951) 276-7550

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a36dfa71-4dd3-4608-9cfb-c7a63ade5531/
  • Direct secure messaging: sansari425919@direct.llu.edu

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 7

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1417324633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7102 STOCKYARD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-883-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "SHAHNAWAZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "PERMIT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.