Individual provider Active NPI

Shabnam Husain, M.D.

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1609987577
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51911 Issued in CA
Practice address
2585 Samaritan Dr
San Jose, CA 95124-4107
Phone
(408) 871-3400
Fax
(408) 871-5219
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 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 A51911 CA Primary

Addresses

Primary practice location

2585 Samaritan Dr
San Jose, CA 95124-4107

Mailing address

2585 Samaritan Dr
San Jose, CA 95124-4107
Phone (408) 871-3400

Other identifiers 1

IdentifierTypeStateIssuer
00A519110MedicaidCA

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
I20080717000531 CA Practitioner - Internal Medicine 2264505643 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

625 Lincoln Ave
San Jose, CA 95126-3785
Phone (408) 871-3400

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 866-4070

Hospital & facility affiliations

  • Sequoia Home Health Home health agency, Milpitas, CA, CCN 058496
  • El Camino Health Hospital, Mountain View, CA, CCN 050308
  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380

Merit-based Incentive Payment System (MIPS)

Final score
89.25 of 100Reported as subgroup
Quality
87.84
Promoting interoperability
100
Improvement activities
40
Cost
76.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DCHS Medical Foundation Internal Medicine CurrentSince Apr 1, 2012 Accepting new patients
Verity Medical Foundation CurrentSince Apr 1, 2012 Accepting new patients
County of Santa Clara CurrentSince May 7, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients
El Camino Health Medical Network, LLC CurrentSince Apr 1, 2019 Accepting new patients
County of Santa Clara Internal Medicine CurrentSince May 7, 2019 Accepting new patients
County of Santa Clara Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
El Camino Health Medical Group Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Seton Medical Center Past Accepting new patients

Locations

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056

9360 N Name Uno
San Francisco, CA 94139
Phone (408) 278-3003

2585 Samaritan Dr
San Jose, CA 95124
Phone (408) 278-3003

400 Race St
San Jose, CA 95126

625 Lincoln Ave
San Jose, CA 95126
Phone (408) 278-3003

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2577 Samaritan Dr
Ste 820
San Jose, CA 95124
Phone (408) 356-8150

Interoperability endpoints

  • Direct secure messaging: shusain18137@icare.elcaminohospital.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1609987577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-871-3400",
            "fax_number": "408-871-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-871-3400",
            "fax_number": "408-871-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSAIN",
        "first_name": "SHABNAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A519110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.