Individual provider Active NPI

Shaheen Reza Modir

  • Clinical Social Worker
  • Orange, CA
National Provider Identifier
1578065470
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114786 Issued in CA
Practice address
4000 W Metropolitan Dr Ste 405
Orange, CA 92868-3504
Phone
(714) 834-3032
NPI assigned
Mar 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114786 CA Primary

Addresses

Primary practice location

4000 W Metropolitan Dr Ste 405
Orange, CA 92868-3504

Mailing address

4000 W Metropolitan Dr Ste 405
Orange, CA 92868-3504

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009002993 CA Practitioner - Clinical Social Worker 3870090343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 W Civic Ctr Dr
448C
Santa Ana, CA 92701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114786CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince Jul 26, 2025 Accepting new patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Jul 26, 2025 Accepting new patients

Locations

2801 Bristol St
#2
Costa Mesa, CA 92626
Phone (714) 850-8463

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

4000 W Metropolitan Dr
Ste 405
Orange, CA 92868
Phone (714) 645-8000

Organizations & group practices 3

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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1578065470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 405",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 405",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-834-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODIR",
        "first_name": "SHAHEEN",
        "middle_name": "REZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.