Individual provider Active NPI

Ramin Shamtob, M.D.

  • Interventional Pain Medicine Physician
  • Encino, CA
National Provider Identifier
1699741389
Registry record updated Aug 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
G75153 Issued in CA
Practice address
16550 Ventura Blvd Ste 401
Encino, CA 91436-5058
Phone
(818) 307-6508
NPI assigned
Feb 23, 2006
Last updated
Aug 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X G75153 CA Primary

Addresses

Primary practice location

16550 Ventura Blvd Ste 401
Encino, CA 91436-5058

Mailing address

16550 Ventura Blvd Ste 401
Encino, CA 91436-5058
Phone (818) 646-0149

Other identifiers 2

IdentifierTypeStateIssuer
00G751530MedicaidCA
00G751530OtherCABLUE SHIELD

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Anesthesia Medical Group, Inc. Anesthesiology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565481600000",
    "number": "1699741389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD STE 401",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365058",
            "telephone_number": "818-646-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD STE 401",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365058",
            "telephone_number": "818-307-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMTOB",
        "first_name": "RAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G75153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G751530",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G751530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.