Individual provider Active NPI

Mona Shah, MD

  • Surgery Physician
  • Lynwood, CA
National Provider Identifier
1750571352
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A101379 Issued in CA
Practice address
3628 E Imperial Hwy
Suite 202
Lynwood, CA 90262-2643
Phone
(310) 631-5000
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A101379 CA Primary

Addresses

Primary practice location

3628 E Imperial Hwy
Suite 202
Lynwood, CA 90262-2643

Mailing address

3628 E Imperial Hwy
Suite 202
Lynwood, CA 90262-2643

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
I20130116000434 CA Practitioner - General Surgery 8921251257 Reassigns benefits to 2 organizations
Practice locations: Lynwood, CA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3628 E Imperial Hwy
Suite 103
Lynwood, CA 90262-2600
Phone (310) 900-5010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)18
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Verity Medical Foundation CurrentSince Dec 5, 2012 Accepting new patients
Shahmdsurgeon a Professional Corporation Surgery CurrentSince May 20, 2023 Accepting new patients
DCHS Medical Foundation Surgery CurrentSince Dec 5, 2012 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

3628 E Imperial Hwy
Ste 103
Lynwood, CA 90262
Phone (310) 900-5010

3628 E Imperial Hwy
Ste 408
Lynwood, CA 90262
Phone (310) 554-4127

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mshah784227@direct.memorialcare.org

Organizations & group practices 4

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 3

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1750571352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE 202",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE 202",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "310-631-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A101379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.