Individual provider Active NPI

Shikib Mostamand, M.D.

  • Pediatric Gastroenterology Physician
  • Palo Alto, CA
National Provider Identifier
1740626969
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
A140840 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
May 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A140840 CA
Pediatrics Physician 208000000X 1740626969 CA
Pediatric Gastroenterology Physician 2080P0206X A140840 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Other practice location 1

22865 Tindaya
Mission Viejo, CA 92692-1326
Phone (949) 244-0019

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
I20190320002841 CA Practitioner - Pediatric Medicine 3072853415 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LPCH Medical Group Div of LucileGroup PAC ID 0840298543, 332 clinicians

Practice addresses (Care Compare)

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 498-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1740626969CAMDPediatrics Physician
A140840CAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Aug 18, 2021 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Nov 27, 2018 Accepting new patients
Stanford Health Care Pediatrics CurrentSince Aug 18, 2021 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Aug 18, 2021 Accepting new patients
Stanford Health Care Pediatrics Current Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients

Locations

4650 W Sunset Blvd
#76
Los Angeles, CA 90027
Phone (323) 669-2113

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Ste MC5519
Palo Alto, CA 94304

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

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.

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1740626969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22865 Tindaya",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926921326",
            "country_code": "US",
            "telephone_number": "949-244-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTAMAND",
        "first_name": "SHIKIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A140840",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "1740626969",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A140840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.