Individual provider Active NPI

Shima Ghavimi, M.D.

  • Gastroenterology Physician
  • Corona, CA
National Provider Identifier
1811316458
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C208749 Issued in CA
Practice address
2097 Compton Ave Ste 103
Corona, CA 92881-7289
Phone
(951) 934-0505
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD-50743 IA
Internal Medicine Physician 207R00000X 29355 WV
Hepatology Physician 207RI0008X C208749 CA
Internal Medicine Physician 207R00000X C208749 CA
Gastroenterology Physician 207RG0100X 29355 WV
Internal Medicine Physician 207R00000X 25MA10563700 NJ
Hepatology Physician 207RI0008X 29355 WV
Gastroenterology Physician 207RG0100X C208749 CA Primary
Gastroenterology Physician 207RG0100X 25MA10563700 NJ
Hepatology Physician 207RI0008X MD-50743 IA
Student in an Organized Health Care Education/Training Program 390200000X 25MA10563700 NJ

Addresses

Primary practice location

2097 Compton Ave Ste 103
Corona, CA 92881-7289

Mailing address

1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone (319) 234-5990

Other practice location 1

185 south orange street
newark, NJ 07103-0710
Phone (202) 480-3808

Other practice location 2

1249 15th St Ste 3000
Huntington, WV 25701-3663
Phone (304) 691-1000

Other practice location 3

2041 Georgia Avenue NW
Washangton, DC 20060
Phone (202) 865-1920

Other practice location 4

1015 S Hackett Rd
Waterloo, IA 50701
Phone (319) 234-5990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shima.ghavimi@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230628002054 IA Practitioner - Gastroenterology 3577852193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Cedar Valley Medical Specialists PCGroup PAC ID 1759291487, 61 clinicians
Allen Memorial Hospital CorporationGroup PAC ID 4284546045, 149 clinicians

Practice addresses (Care Compare)

1015 S Hackett Rd
Cedar Valley Digestive Health Cente
Waterloo, IA 50701-3500
Phone (319) 234-5990

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3913

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110
  • Buchanan County Health Center Hospital, Independence, IA, CCN 161335
  • Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
  • Floyd County Medical Center Hospital, Charles City, IA, CCN 161347
  • Grundy County Memorial Hospital Hospital, Grundy Center, IA, CCN 161303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-50743IAMDHepatology Physician
25MA10563700NJMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Valley Medical Specialists PC Gastroenterology CurrentSince Aug 4, 2023 Accepting new patients
Cedar Valley Medical Specialists PC CurrentSince Aug 4, 2023 Accepting new patients
Allen Memorial Hospital Corporation Current Accepting new patients
Allen Memorial Hospital Corporation Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients

Locations

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

1015 S Hackett Rd
Waterloo, IA 50701
Phone (319) 234-5990

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

Interoperability endpoints

  • Direct secure messaging: shima.ghavimi@marshall.cernerdirect.com

Organizations & group practices 6

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 5

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1811316458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-234-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 COMPTON AVE STE 103",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817289",
            "telephone_number": "951-934-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 south orange street",
            "address_purpose": "LOCATION",
            "city": "newark",
            "state": "NJ",
            "postal_code": "071030710",
            "country_code": "US",
            "telephone_number": "202-480-3808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1249 15th St Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013663",
            "country_code": "US",
            "telephone_number": "304-691-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Georgia Avenue NW",
            "address_purpose": "LOCATION",
            "city": "Washangton",
            "state": "DC",
            "postal_code": "20060",
            "country_code": "US",
            "telephone_number": "202-865-1920",
            "fax_number": "202-865-7199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 S Hackett Rd",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "50701",
            "country_code": "US",
            "telephone_number": "319-234-5990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHAVIMI",
        "first_name": "SHIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "MD-50743",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29355",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "CA",
            "license": "C208749",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C208749",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "29355",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10563700",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "WV",
            "license": "29355",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C208749",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA10563700",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "IA",
            "license": "MD-50743",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "25MA10563700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shima.ghavimi@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1249 15th St Ste 3000",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.