Individual provider Active NPI

Sohum Chetan Shah

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1679036396
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A188332 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 430
Los Angeles, CA 90095-2351
Phone
(310) 794-7274
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 694200 TX
Obstetrics & Gynecology Physician 207V00000X A188332 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 430
Los Angeles, CA 90095-2351

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

6651 Main St Ste 1020
Houston, TX 77030-2351
Phone (832) 826-7372

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
I20230907004157 CA Practitioner - Obstetrics/Gynecology 0648634774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.28 of 100Reported as group
Quality
76.27
Promoting interoperability
100
Improvement activities
40
Cost
68.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A188332CAMDObstetrics & Gynecology Physician
694200TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Obstetrics & Gynecology CurrentSince Aug 1, 2023 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 430
Los Angeles, CA 90095
Phone (310) 208-4492

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

200 Medical Plz
Ste 430
Los Angeles, CA 90095
Phone (310) 794-8282

File 54456
Los Angeles, CA 90074

1245 16th St
Ste 202
Santa Monica, CA 90404
Phone (310) 453-1982

2001 Santa Monica Blvd
Ste 380
Santa Monica, CA 90404
Phone (310) 899-7500

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.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1679036396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952351",
            "telephone_number": "310-794-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6651 Main St Ste 1020",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302351",
            "country_code": "US",
            "telephone_number": "832-826-7372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SOHUM",
        "middle_name": "CHETAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "694200",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A188332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.