NPIMap

Individual provider Active NPI

Shahriar Ghodsian, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Thousand Oaks, CA
National Provider Identifier
1699728410
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A72696 Issued in CA
Practice address
2100 Lynn Rd #115
Thousand Oaks, CA 91360-8031
Phone
(800) 266-4761
NPI assigned
May 19, 2006
Last updated
Aug 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A72696 CA Primary
Pulmonary Disease Physician 207RP1001X A72696 CA

Addresses

Primary practice location

2100 Lynn Rd #115
Thousand Oaks, CA 91360-8031

Mailing address

PO Box 5248
Beverly Hills, CA 90209-5248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031117000734 CA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1759295439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
University of California, Geffen School of Medicine, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

415 Rolling Oaks Dr
Suite 210
Thousand Oaks, CA 91361-1044
Phone (800) 266-4761

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cozy Care Hospice LLC Current Accepting new patients
Cozy Care Units LLC Current Accepting new patients
Cozy Care Congregate Living Health Facility Inc. Current Accepting new patients
Midway Sleep Lab LLC Past Accepting new patients
Delphi OB-GYN Group of Montgomery County LLC Past Accepting new patients
Abraham Ishaaya, M.D. a Professional Corporation Critical Care Medicine PastSince Sep 30, 2015 Accepting new patients
Templeton Inpatient Physicians PC Critical Care Medicine Past Accepting new patients
Medipro Medical Group Inc Past Accepting new patients

Locations

1534 N Moorpark Rd
Thousand Oaks, CA 91360
Phone (805) 497-1800

415 Rolling Oaks Dr
Ste 210
Thousand Oaks, CA 91361
Phone (800) 266-4761

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1699728410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5248",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902095248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LYNN RD #115",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608031",
            "telephone_number": "800-266-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHODSIAN",
        "first_name": "SHAHRIAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A72696",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A72696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.