Individual provider Active NPI

Hooman Shabatian, M.D.

  • Surgery Physician
  • Encino, CA
National Provider Identifier
1720201379
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A87662 Issued in CA
Practice address
17609 Ventura Blvd Ste 106
Encino, CA 91316-3866
Phone
(818) 774-2755
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X A87662 CA Primary

Addresses

Primary practice location

17609 Ventura Blvd Ste 106
Encino, CA 91316-3866

Mailing address

17609 Ventura Blvd Ste 106
Encino, CA 91316-3866
Phone (818) 774-2755

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
I20080506000180 CA Practitioner - General SurgeryPractitioner - Other (Physician) 4385723105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17609 Ventura Blvd
Suite 106
Encino, CA 91316-3866
Phone (818) 774-2755

Hospital & facility affiliations

  • Southern California Hospital at Hollywood Hospital, Hollywood, CA, CCN 050135
  • Foothill Regional Medical Center Hospital, Tustin, CA, CCN 050780

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87662CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West la Medical Group Multi-Specialty CurrentSince Feb 15, 2023 Accepting new patients
Prime Urgent Care Inc Multi-Specialty CurrentSince Apr 1, 2024 Accepting new patients
Prestige Surgical Center LLC PastSince Jul 1, 2023 Accepting new patients
Mount Sinai Surgery Center LLC Past Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients

Locations

17609 Ventura Blvd
Ste 106
Encino, CA 91316
Phone (818) 774-2457

17609 Ventura Blvd
Ste LL08
Encino, CA 91316
Phone (818) 774-2755

2572 Atlantic Ave
Long Beach, CA 90806
Phone (562) 424-0931

9220 Haven Ave
Ste 320
Rch Cucamonga, CA 91730
Phone (818) 774-2755

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1720201379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 106",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163866",
            "telephone_number": "818-774-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 106",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163866",
            "telephone_number": "818-774-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABATIAN",
        "first_name": "HOOMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A87662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.