Sherif A Aziz, MD

Individual provider Active NPI Psychiatry Physician · Carson City, MI

NPI 1508939588 · NPPES record last updated Nov 29, 2021

Key facts

NPI
1508939588
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
4301086737 (MI)
Practice address
406 E Elm St
Carson City, MI 48811-9693
Phone
(989) 584-3971
Fax
(989) 584-6734
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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.

Medicare Care Compare profile

Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical Group (11,250 clinicians)

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090602000618 CA Practitioner - Psychiatry 9638178460 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301086737MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group Current
since Jul 15, 2018
Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group Current
since Apr 19, 2009
Accepting new patients
Southern California Permanente Medical Group Current
since Apr 19, 2009
Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301086737 MI Yes

Addresses

Primary practice location

406 E Elm St
Carson City, MI 48811-9693

Mailing address

36300 Dequindre Rd
Apt 108
Sterling Heights, MI 48310-4243

Other identifiers

IdentifierTypeStateIssuer
4301086737OtherMIMI PHYSICIAN LICENSE
05419932OtherECFMG CERTIFICATE

Electronic endpoints

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

Other providers in Carson City, MI

All providers in Carson City, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.