NPIMap

Individual provider Active NPI

Shima Hadidchi, M.D.

  • Family Medicine Physician
  • Victorville, CA
National Provider Identifier
1780975839
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A120144 Issued in CA
Practice address
12740 Hesperia Rd Ste a
Victorville, CA 92395-8306
Phone
(760) 998-1999
Fax
(760) 881-3555
NPI assigned
Apr 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A120144 CA Primary

Addresses

Primary practice location

12740 Hesperia Rd Ste a
Victorville, CA 92395-8306

Mailing address

12740 Hesperia Rd Ste B
Victorville, CA 92395-8306
Phone (805) 698-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120924000321 CA Practitioner - Family Practice 2668620287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shima Hadidchi MD a Professional CorpGroup PAC ID 5991137911, 3 clinicians
Golden Health and Beauty Center IncGroup PAC ID 8224376033, 3 clinicians

Practice addresses (Care Compare)

12740 Hesperia Rd
Suite a
Victorville, CA 92395-8306
Phone (760) 998-1999

16661 Ventura Blvd
Suite 700
Encino, CA 91436-1992
Phone (818) 285-8446

Hospital & facility affiliations

  • Valde Home Health, Inc Home health agency, Victorville, CA, CCN 053161
  • Gracelight Home Health Home health agency, Victorville, CA, CCN 059597
  • Imperial Home Health Home health agency, Victorville, CA, CCN 059033

Merit-based Incentive Payment System (MIPS)

Final score
97.25 of 100Reported as group
Quality
100
Improvement activities
40
Cost
64.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Health & Beauty Center Inc CurrentSince Jan 27, 2020 Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

16661 Ventura Blvd
Ste 700
Encino, CA 91436
Phone (818) 285-8446

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1780975839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "805-698-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-998-1999",
            "fax_number": "760-881-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADIDCHI",
        "first_name": "SHIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A120144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.