Individual provider Active NPI

Mohammad Jehad Shakfeh, M.D

  • Gastroenterology Physician
  • Chino, CA
National Provider Identifier
1457399032
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C43299 Issued in CA
Practice address
12598 Central Ave
Suite 101
Chino, CA 91710-3502
Phone
(909) 606-4860
Fax
(909) 606-1653
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C43299 CA Primary

Addresses

Primary practice location

12598 Central Ave
Suite 101
Chino, CA 91710-3502

Mailing address

12598 Central Ave
Suite 101
Chino, CA 91710-3502
Phone (909) 606-4860

Other identifiers 1

IdentifierTypeStateIssuer
00C432991MedicaidCA

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
I20051216000798 CA Practitioner - Gastroenterology 2062325392 Practice locations: Chino, CA; Rancho Cucamonga, CA

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12598 Central Ave
Suite 101
Chino, CA 91710-3500
Phone (909) 606-4860

9140 Haven Ave
Suite 115
Rancho Cucamonga, CA 91730-5414
Phone (909) 606-4860

Hospital & facility affiliations

  • Montclair Hospital Medical Center Hospital, Montclair, CA, CCN 050758
  • Chino Valley Medical Center Hospital, Chino, CA, CCN 050586

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy201
Upper gastrointestinal (GI) endoscopy for acid reflux100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C43299CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Medical Center of Chino Gastroenterology Past Accepting new patients
Marian a. Fedak M.D. Medical Corporation Past Accepting new patients
Ep Quianzon, MD Inc Past Accepting new patients
Muhammad Hammami MD Inc Gastroenterology PastSince Feb 19, 2023 Accepting new patients
Jingjie Xue Inc PastSince Aug 1, 2016 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1457399032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12598 CENTRAL AVE",
            "address_2": "SUITE 101",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103502",
            "telephone_number": "909-606-4860",
            "fax_number": "909-606-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12598 CENTRAL AVE",
            "address_2": "SUITE 101",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103502",
            "telephone_number": "909-606-4860",
            "fax_number": "909-606-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKFEH",
        "first_name": "MOHAMMAD",
        "middle_name": "JEHAD",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C43299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C432991",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.