Individual provider Active NPI

Nour Shahab, PA-C

  • Physician Assistant
  • Pasadena, CA
National Provider Identifier
1659876753
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55438 Issued in CA
Practice address
301 S Fair Oaks Ave Ste 305
Pasadena, CA 91105-2562
Phone
(626) 440-7325
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55438 CA Primary

Addresses

Primary practice location

301 S Fair Oaks Ave Ste 305
Pasadena, CA 91105-2562

Mailing address

541 W Colorado St Ste 205
Glendale, CA 91204-3640
Phone (323) 254-0046

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250322000000 CA Practitioner - Physician Assistant 3971025644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 303
Los Angeles, CA 90017-4803
Phone (213) 977-1214

1505 Wilson Ter
Suite 200
Glendale, CA 91206-4073
Phone (818) 409-0105

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55438CAMDPeriodontist
PA55438CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Hematology-Oncology Medical Group CurrentSince Mar 3, 2025 Accepting new patients
Los Angeles Hematology-Oncology Medical Group CurrentSince Mar 3, 2025 Accepting new patients

Locations

1211 W La Palma Ave
Ste 103
Anaheim, CA 92801
Phone (714) 535-3660

260 E Ontario Ave
Ste 101
Corona, CA 92879
Phone (951) 268-7746

11180 Warner Ave
Ste 351
Fountain Vly, CA 92708
Phone (714) 210-2300

1505 Wilson Ter
Ste 200
Glendale, CA 91206
Phone (818) 243-0477

541 W Colorado St
Ste 205
Glendale, CA 91204
Phone (323) 254-0046

1245 Wilshire Blvd
Ste 303
Los Angeles, CA 90017
Phone (213) 977-1214

15211 Vanowen St
Ste 201
Van Nuys, CA 91405
Phone (818) 574-3798

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1659876753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043640",
            "telephone_number": "323-254-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S FAIR OAKS AVE STE 305",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052562",
            "telephone_number": "626-440-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAB",
        "first_name": "NOUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.