Individual provider Active NPI

Mina Shakiba, MD

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1427329119
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A130397 Issued in CA
Practice address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone
(562) 933-2000
NPI assigned
Jan 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A130397 CA Primary

Addresses

Primary practice location

2801 Atlantic Ave
Long Beach, CA 90806-1701

Mailing address

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-2000

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
I20150119000005 CA Practitioner - Internal Medicine 3375867500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 728-5034

Hospital & facility affiliations

  • Hygieia Home Health Inc Home health agency, Lakewood, CA, CCN 557541
  • Excell Home Care Inc Home health agency, Paramount, CA, CCN 058212
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Merit-based Incentive Payment System (MIPS)

Final score
38.53 of 100Reported as group
Quality
20.07
Promoting interoperability
0
Improvement activities
0
Cost
75.03

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130397CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners a Medical Group CurrentSince Oct 20, 2024 Accepting new patients
Kansal Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Oct 5, 2019 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine CurrentSince Oct 20, 2024 Accepting new patients
Prohealth Partners, a Medical Group Internal Medicine Current Accepting new patients
Prohealth Partners a Medical Group Inc Internal Medicine Past Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

1426 Montana Ave
Ste 2
Santa Monica, CA 90403
Phone (310) 388-6798

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Organizations & group practices 6

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 3

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": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1427329119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIBA",
        "first_name": "MINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A130397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.