Shahrooz Sean Kelishadi, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A127984 Issued in CA

Practice address

500 Superior Ave
Ste 340
Newport Beach, CA 92663-3609

Phone

(949) 515-7874

NPI assigned

Feb 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Superior Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Newport Beach, CA
  • NPI 1154998771
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1831225952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE",
            "address_2": "STE 340",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633609",
            "telephone_number": "949-515-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE",
            "address_2": "STE 340",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633609",
            "telephone_number": "949-515-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELISHADI",
        "first_name": "SHAHROOZ",
        "middle_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A127984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathalie Keeler
• Kyle Edward Keffer, MS, LMFT
• Sheri Denham Keffer, PH.D MFT
• Mitchell S Keil, PSYD
• Keith H Tam DDS Inc
• Dylan Joseph Kelley
• Selah Kelley
• Timothy Kelley, MD
• Kelli a. Fox
• Kelli Junker DDS Inc

• Plastic Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.