Individual provider Active NPI

Shaina Nilofar Kashanirokh

  • Physician Assistant
  • Tarzana, CA
National Provider Identifier
1760224778
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64196 Issued in CA
Practice address
19043 Friar St
Tarzana, CA 91335-6734
Phone
(818) 430-4153
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 64196 CA Primary

Addresses

Primary practice location

19043 Friar St
Tarzana, CA 91335-6734

Mailing address

19043 Friar St
Tarzana, CA 91335-6734

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
I20240806004738 CA Practitioner - Physician Assistant 4385181437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altea Medical California PCGroup PAC ID 1850740150, 84 clinicians

Practice addresses (Care Compare)

16955 Vanowen St
Van Nuys, CA 91406-4542
Phone (818) 343-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64196CAMDPhysician Assistant

Organizations & group practices 1

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1760224778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19043 FRIAR ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19043 FRIAR ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356734",
            "telephone_number": "818-430-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHANIROKH",
        "first_name": "SHAINA",
        "middle_name": "NILOFAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.