Shala Rahbar Fardin, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A98841 Issued in CA

Practice address

2330 Marinship Way Ste 370
Sausalito, CA 94965-2853

Phone

(415) 887-9758

Fax

(415) 887-9763

NPI assigned

Feb 26, 2007

Last updated

Sep 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shala Rahbar Former name

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

Merit-based Incentive Payment System (MIPS)

Final score

90.43 of 100Reported as group

Quality

80.85

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfardin@smd.emadirect.md

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.

• Southern Marin Dermatology, Inc.

  • Dermatology Physician
  • Sausalito, CA
  • NPI 1487090924
  Medicare reassignment NPD
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• Regents Univ of California UCSF

  dba UCSF Physician Group

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1720114432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 MARINSHIP WAY STE 370",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949652853",
            "telephone_number": "415-887-9758",
            "fax_number": "415-887-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 MARINSHIP WAY STE 370",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949652853",
            "telephone_number": "415-887-9758",
            "fax_number": "415-887-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDIN",
        "first_name": "SHALA",
        "middle_name": "RAHBAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "P-230971",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A98841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHALA",
            "last_name": "RAHBAR",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Evan Shepherd Reiff, L.Ac. (Health For Heroes)
• Carter C Evans
• Stephanie Evans, PHD
• Tamara Falvai
• Jeffrey Lawrence Farber, MSW, LCSW
• Jane Victoria Farley, LMHC, MFT
• Leni Michelle Felton, C.C.N. CERT CLIN NUT
• Sara E Fenton, MS RD
• Celina Noelle Fine, PA
• Cheri J. Forrester, MD

• Dermatology Physician in Sausalito, CA
• Providers in Sausalito, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.