Individual provider Active NPI

Shadi Vahdat, MD

  • Internal Medicine Physician
  • Redwood City, CA
National Provider Identifier
1760494314
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A70964 Issued in CA
Practice address
170 Alameda de Las Pulgas
Redwood City, CA 94062-2751
Phone
(650) 369-5811
NPI assigned
Aug 12, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A70964 CA Primary

Addresses

Primary practice location

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2777

Other identifiers 1

IdentifierTypeStateIssuer
00A709640OtherCAMEDI-CAL PPIN #

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
I20040611000670 CA Practitioner - Internal Medicine 5294718078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1993
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

2020 Santa Monica Blvd
Santa Monica, CA 90404-2023
Phone (310) 458-2381

7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A70964CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Internal Medicine CurrentSince Mar 1, 2007 Accepting new patients
Northeast Valley Health Corporation CurrentSince Feb 9, 2022 Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients
The Regents of the University of California CurrentSince Mar 1, 2007 Accepting new patients
Northeast Valley Health Corporation CurrentSince Feb 9, 2022 Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients
Dignity Health Past Accepting new patients
Kristine Burke MD, Inc. Past Accepting new patients
California Em-I Medical Services Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Ste 7501
Los Angeles, CA 90095
Phone (310) 267-9643

File 55737
Los Angeles, CA 90074

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

1250 16th St
Ste A454
Santa Monica, CA 90404
Phone (310) 301-9469

2020 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 458-2381

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: shadi.vahdat.p1@direct.nevhc.nextgenshare.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1760494314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ALAMEDA DE LAS PULGAS",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622751",
            "telephone_number": "650-369-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHDAT",
        "first_name": "SHADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PPIN #",
            "identifier": "00A709640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.