Individual provider Active NPI

Pejman Eli Shirazy, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Encino, CA
National Provider Identifier
1669470068
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A76100 Issued in CA
Practice address
16952 Ventura Blvd
Encino, CA 91316-4197
Phone
(818) 789-3964
Fax
(818) 789-3967
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A76100 CA Primary

Addresses

Primary practice location

16952 Ventura Blvd
Encino, CA 91316-4197

Mailing address

16952 Ventura Blvd
Encino, CA 91316-4197
Phone (818) 789-3964

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
I20040320000499 CA Practitioner - Physical Medicine and Rehabilitation 1456242569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
90.29
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76100CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Pain Management Center, a Medical Corporation Pain Medicine CurrentSince Apr 30, 2003 Accepting new patients
Dtla Pain Surgery Center Inc Current Accepting new patients
Advanced Pain Center, Inc. Current Accepting new patients
Elite Ortho Surgical Institute, Inc. Current Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

16952 Ventura Blvd
Ste 100
Encino, CA 91316
Phone (818) 789-3964

16952 Ventura Blvd
Ste 200B
Encino, CA 91316
Phone (818) 789-3964

16952 Ventura Blvd
Encino, CA 91316
Phone (818) 789-3964

16952 Ventura Blvd
Ste 200A
Encino, CA 91316
Phone (818) 789-3964

Interoperability endpoints

  • Direct secure messaging: pejman.shirazy@578416079011844.direct.elationemr.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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1669470068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZY",
        "first_name": "PEJMAN",
        "middle_name": "ELI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A76100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.