Individual provider Active NPI

Nisha Nitin Shah, M.D.

  • Allergy & Immunology Physician
  • Lancaster, CA
National Provider Identifier
1437300407
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A110678 Issued in CA
Practice address
43112 15TH St W
West BLDG Dept of Allergy Lancaster Mob
Lancaster, CA 93534-6219
Phone
(661) 729-7100
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A110678 CA
Allergy & Immunology Physician 207K00000X A110678 CA Primary

Addresses

Primary practice location

43112 15TH St W
West BLDG Dept of Allergy Lancaster Mob
Lancaster, CA 93534-6219

Mailing address

43112 15TH St W
West BLDG Dept of Allergy Lancaster Mob
Lancaster, CA 93534-6219
Phone (661) 729-7100

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20151013002032 CA Practitioner - Pediatric MedicinePractitioner - Allergy/Immunology 5597927004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Allergy/Immunology
Education
Albany Medical College of Union University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

43112 15TH St W
Lancaster, CA 93534-6219
Phone (661) 726-2378

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 26, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 26, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 4

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1437300407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "address_2": "WEST BLDG DEPT OF ALLERGY LANCASTER MOB",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219",
            "telephone_number": "661-729-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "address_2": "WEST BLDG DEPT OF ALLERGY LANCASTER MOB",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219",
            "telephone_number": "661-729-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NISHA",
        "middle_name": "NITIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A110678",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A110678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.