Shahram Javaheri, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A064239 Issued in CA

Practice address

26691 Plaza Ste 150
Mission Viejo, CA 92691-6329

Phone

(949) 389-0660

Fax

(949) 389-0668

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Gastroenterology

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Western Gastroenterology Care Associates IncGroup PAC ID 2062780307, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
• St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
• Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Shahram Javaheri, MD, Inc.

  • Gastroenterology Physician
  • Mission Viejo, CA
  • NPI 1760589097
  Medicare reassignment Authorized official
• Western Gastroenterology Care Associates Inc

  • Gastroenterology Physician
  • La Mesa, CA
  • NPI 1508391822
  Medicare reassignment Care Compare group
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Emergency Associates Corporation

  • Emergency Medicine Physician
  • Rancho Mirage, CA
  • NPI 1003866120
  Medicare reassignment NPD
• Inpatient Management Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1093729915
  NPD (past)
• Mission Endoscopy Center Inc

  • Ambulatory Surgical Clinic/Center
  • Mission Viejo, CA
  • NPI 1033368378
  NPD (past)
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1013080084
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1235218785
  Care Compare affiliation

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1497861439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12512",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585065",
            "telephone_number": "949-389-0660",
            "fax_number": "949-389-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-389-0660",
            "fax_number": "949-389-0668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVAHERI",
        "first_name": "SHAHRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "MED-PHYS-LIC-114422",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A064239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A642390",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHREVIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Jaramillo, M.A., CCC-SLP
• Alexis Jardine, MS, LMFT
• Joseph Jardine
• Jason Pierce DO, a Medical Corporation
• Gloria L Jaucian, M.D.
• Jeffrey Flores DDS Inc.
• Jeffrey S Cohen
• Cathearine Jenkins Hall, PHD
• Christina Jenkins, MD
• Stephen Woodrow Jenkins, M.D.

• Gastroenterology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.