Individual provider Active NPI

Negean Shahnematollahi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1841832599
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95012961 Issued in CA
Practice address
1350 Columbia St Unit 800
San Diego, CA 92101-3456
Phone
(559) 960-0290
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95012961 CA Primary

Addresses

Primary practice location

1350 Columbia St Unit 800
San Diego, CA 92101-3456

Mailing address

1350 Columbia St Unit 800
San Diego, CA 92101-3456

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200422000555 CA Practitioner - Nurse Practitioner 9234569880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert Zalewski-Zaragoza MD IncGroup PAC ID 6507084191, 10 clinicians

Practice addresses (Care Compare)

1350 Columbia St
Unit 800
San Diego, CA 92101-3456
Phone (619) 255-1652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Zalewski-Zaragoza, MD, Inc CurrentSince Apr 15, 2020 Accepting new patients

Locations

780 Bay Blvd
Ste 203
Chula Vista, CA 91910
Phone (619) 255-1652

1350 Columbia St
Unit 800
San Diego, CA 92101
Phone (619) 244-4420

438 Camino del Rio S
Ste 210
San Diego, CA 92108
Phone (619) 255-1652

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1841832599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST UNIT 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST UNIT 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013456",
            "telephone_number": "559-960-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHNEMATOLLAHI",
        "first_name": "NEGEAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.