Active NPI
Fardis Shahrivar, MD
- Pediatrics Physician
- San Jose, CA
National Provider Identifier
1689779746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- AO49985
- Practice address
- 200 Jose Figueres Ave
Suite 295
San Jose, CA 95116-1500 - Phone
- (408) 729-4473
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | AO49985 | CA | Primary |
Addresses
Primary practice location
200 Jose Figueres Ave
Suite 295
San Jose, CA 95116-1500
Mailing address
200 Jose Figueres Ave
Suite 295
San Jose, CA 95116-1500
Phone (408) 729-4473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A499851 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AO49985 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| El Camino Hospital | Past | Accepting new patients | |
| Good Samaritan Hospital, L.P. | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Mountain View, CA
- NPI 1093712374
-
- General Acute Care Hospital
- San Jose, CA
- NPI 1376595777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1689779746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 JOSE FIGUERES AVE",
"address_2": "SUITE 295",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161500",
"telephone_number": "408-729-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JOSE FIGUERES AVE",
"address_2": "SUITE 295",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161500",
"telephone_number": "408-729-4473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHRIVAR",
"first_name": "FARDIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "AO49985",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A499851",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.