NPIMap

Individual provider Active NPI

Mona S Shah, MD

  • Internal Medicine Physician
  • San Pedro, CA
National Provider Identifier
1609087543
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A056119 Issued in CA
Practice address
1600 S Gaffey St
San Pedro, CA 90731-4628
Phone
(310) 548-0201
Fax
(310) 548-4492
NPI assigned
May 24, 2007
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A056119 CA Primary

Addresses

Primary practice location

1600 S Gaffey St
San Pedro, CA 90731-4628

Mailing address

1600 S Gaffey St
San Pedro, CA 90731-4628
Phone (310) 548-0201

Other practice location 1

1366 W 7th St
San Pedro, CA 90732-3517
Phone (310) 308-3623 ext. 3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050103000603 CA Practitioner - Internal Medicine 3678531902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Mona Shah Professional CorporationGroup PAC ID 2062548084, 11 clinicians

Practice addresses (Care Compare)

1600 S Gaffey St
San Pedro, CA 90731-4628
Phone (310) 548-0201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue29
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A056119CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mona Shah Professional Corporation Internal Medicine CurrentSince Jan 21, 2010 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Washington Township Hospital Development Corporation Past Accepting new patients
Zeljko Zic M.D. Inc. Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

1294 W 6th St
Ste 205
San Pedro, CA 90731
Phone (310) 548-0201

1360 W 6th St
Ste 120
San Pedro, CA 90732
Phone (310) 428-4699

1366 W 7th St
San Pedro, CA 90732
Phone (310) 548-0478

1600 S Gaffey St
San Pedro, CA 90731
Phone (310) 548-0201

621 S Butte St
San Pedro, CA 90732
Phone (310) 548-1422

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mona.shah@dmspc.eclinicaldirectplus.com

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

Hospital & facility affiliations 7

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1609087543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314628",
            "telephone_number": "310-548-0201",
            "fax_number": "310-548-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314628",
            "telephone_number": "310-548-0201",
            "fax_number": "310-548-4492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1366 W 7th St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907323517",
            "country_code": "US",
            "telephone_number": "310-308-3623 x3221",
            "fax_number": "310-547-3340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MONA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A056119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.