Individual provider Active NPI

Foad Joseph Shirazian, O.D.

  • Optometrist
  • Tarzana, CA
National Provider Identifier
1780700989
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11746T Issued in CA
Practice address
18399 Ventura Blvd Ste 10
Tarzana, CA 91356-6416
Phone
(818) 757-3090
Fax
(818) 757-0318
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11746T CA Primary

Addresses

Primary practice location

18399 Ventura Blvd Ste 10
Tarzana, CA 91356-6416

Mailing address

18399 Ventura Blvd Ste 10
Tarzana, CA 91356-6416
Phone (818) 757-3200

Other identifiers 1

IdentifierTypeStateIssuer
BQ107AMedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000814 CA Practitioner - Optometry 2769459817 Practice locations: Tarzana, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18399 Ventura Blvd
Suite 10
Tarzana, CA 91356-6416
Phone (818) 757-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11746TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foad J. Shirazian Optometrist PastSince Sep 1, 2010 Accepting new patients

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1780700989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD STE 10",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566416",
            "telephone_number": "818-757-3200",
            "fax_number": "818-757-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD STE 10",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566416",
            "telephone_number": "818-757-3090",
            "fax_number": "818-757-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZIAN",
        "first_name": "FOAD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11746T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BQ107A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.