Nader Shakir, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A-19135 Issued in CA

Practice address

17053 Foothill Blvd
Fontana, CA 92335-3574

Phone

(909) 347-1300

Fax

(909) 347-1302

NPI assigned

Jun 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, CA2 enrollments

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 2

Specialty

Psychiatry

Education

Lake Erie Col of Osteo Med at Seton Hill Univ, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Prairie Ridge Integrated Behavioral HealthcareGroup PAC ID 6800169194, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023
  Medicare reassignment Care Compare group NPD
• Prairie Ridge Integrated Behavioral Healthcare

  • Substance Abuse Rehabilitation Facility
  • Mason City, IA
  • NPI 1952443632
  Medicare reassignment Care Compare group NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, CA
  • NPI 1346950904
  NPD
• County of San Bernardino

  • Adult Mental Health Clinic/Center
  • Colton, CA
  • NPI 1982813275
  NPD
• Prairie Ridge Integrated Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mason City, IA
  • NPI 1801637061
  NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1750811535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17053 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353574",
            "telephone_number": "909-347-1300",
            "fax_number": "909-347-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17053 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353574",
            "telephone_number": "909-347-1300",
            "fax_number": "909-347-1302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 N Eisenhower Ave",
            "address_purpose": "LOCATION",
            "city": "Mason City",
            "state": "IA",
            "postal_code": "504011521",
            "country_code": "US",
            "telephone_number": "641-424-2391",
            "fax_number": "641-424-0783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1330 E Cooley Dr",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923243905",
            "country_code": "US",
            "telephone_number": "909-423-0750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKIR",
        "first_name": "NADER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "DO-05450",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A-19135",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05450",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A-19135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbid Shah, M.D.
• Dampa Nikhil Shah, MD
• Sara Marie Shah, DO, MPH
• Shriraj Ashok Shah, DMD
• Halima Tasneem Shahabuddin, M.D.
• Shamrock Lodge, Inc
• Nora Taher Shams, DDS
• Caitlyn Shankle Joy Shankle
• Yi Shao
• Faye Shapiro

• Psychiatry Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.