NPIMap

Individual provider Active NPI

Tariq Shah, M.D.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1750452116
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A66881 Issued in CA
Practice address
700 W 7TH St Ste S270
Los Angeles, CA 90017-3977
Phone
(213) 409-6686
Fax
(213) 988-8390
NPI assigned
Nov 10, 2006
Last updated
Jan 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A66881 CA Primary

Addresses

Primary practice location

700 W 7TH St Ste S270
Los Angeles, CA 90017-3977

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

2200 W 3rd St
Suite 500
Los Angeles, CA 90057-1932
Phone (213) 207-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824001455 CA Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Geriatric Medicine 7416921465 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2021 Santa Monica Blvd
Suite 421E
Santa Monica, CA 90404-2144
Phone (310) 453-9001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66881CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Wong Nurse Practitioner CurrentSince Jul 12, 2024 Accepting new patients
Kidney Disease Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Dec 15, 2023 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Providence Saint John's Health Center Past Accepting new patients
Wound Away PastSince Jul 12, 2024 Accepting new patients
Saint John's Health Clinic Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Mendez Transplant and Urological Medical Group, Inc. Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Barlow Respiratory Hospital Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

1505 Wilson Ter
Ste 155
Glendale, CA 91206
Phone (818) 500-4055

14525 Valley View Ave
Ste E
Santa Fe Springs, CA 90670
Phone (714) 420-5268

2021 Santa Monica Blvd
Ste 421E
Santa Monica, CA 90404
Phone (310) 453-8709

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15679/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tariq.shah.1@15679.direct.athenahealth.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1750452116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 7TH ST STE S270",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173977",
            "telephone_number": "213-409-6686",
            "fax_number": "213-988-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 W 3rd St",
            "address_2": "SUITE 500",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900571932",
            "country_code": "US",
            "telephone_number": "213-207-5711",
            "fax_number": "213-413-0190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TARIQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A66881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.