Individual provider Active NPI

Valentina R Dalili-Shoaie, MD

  • Clinical Genetics (M.D.) Physician
  • Newport Beach, CA
National Provider Identifier
1447224126
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
A103357 Issued in CA
Practice address
510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone
(949) 791-3001
Fax
(949) 791-3096
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X A103357 CA Primary
Internal Medicine Physician 207R00000X A103357 CA

Addresses

Primary practice location

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663

Mailing address

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone (949) 791-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090227000200 CA Practitioner - Medical Genetics and GenomicsPractitioner - Internal Medicine 8325046022 Reassigns benefits to 1 organization
I20200421002938 IL Practitioner - Medical Genetics and GenomicsPractitioner - Internal Medicine 8325046022 Reassigns benefits to 1 organization
I20220406002166 WI Practitioner - Medical Genetics and GenomicsPractitioner - Internal Medicine 8325046022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25040OKMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Mar 1, 2014 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 9, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Mercy Health System Corporation CurrentSince Mar 9, 2022 Accepting new patients
Rockford Health Physicians CurrentSince Feb 17, 2020 Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1401 Avocado Ave
Ste 303
Newport Beach, CA 92660
Phone (949) 717-0072

510 Superior Ave
Ste 200B
Newport Beach, CA 92663
Phone (800) 400-4624

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: vdalilishoaie67860@direct.mhemail.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1447224126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001",
            "fax_number": "949-791-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001",
            "fax_number": "949-791-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALILI-SHOAIE",
        "first_name": "VALENTINA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "A103357",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A103357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.