Individual provider Active NPI

Nesha Yahya Shami, PA

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1730614801
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1097735 Issued in CA
Practice address
1777 N Bellflower Blvd Ste 210
Long Beach, CA 90815-4020
Phone
(562) 986-1450
Fax
(562) 986-1455
NPI assigned
Apr 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1097735 CA Primary

Addresses

Primary practice location

1777 N Bellflower Blvd Ste 210
Long Beach, CA 90815-4020

Mailing address

1777 N Bellflower Blvd Ste 210
Long Beach, CA 90815-4020

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170918000791 CA Practitioner - Physician Assistant 5193099968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54457CAMDGeneral Practice Dentistry
1097735CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Facility Health Care Solutions Inc CurrentSince Aug 28, 2017 Accepting new patients
Skilled Facility Health Care Solutions Inc CurrentSince Aug 28, 2017 Accepting new patients

Locations

3747 Foothill Blvd
#B140
La Crescenta, CA 91214
Phone 3104455999255

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

6401 33rd St
Riverside, CA 92509
Phone (909) 681-2200

1340 15th St
Santa Monica, CA 90404
Phone (310) 451-9700

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.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1730614801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154020",
            "telephone_number": "562-986-1450",
            "fax_number": "562-986-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMI",
        "first_name": "NESHA",
        "middle_name": "YAHYA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1097735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.