Individual provider Active NPI

Shadman Habibi, CNM

  • Advanced Practice Midwife
  • Los Angeles, CA
National Provider Identifier
1851435424
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1587 Issued in CA
Practice address
430 OB-GYN Consultation
200 UCLA Medical Plaza, Suite 430
Los Angeles, CA 90095-6928
Phone
(310) 794-7274
Fax
(310) 794-7236
NPI assigned
Feb 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 1587 CA Primary

Addresses

Primary practice location

430 OB-GYN Consultation
200 UCLA Medical Plaza, Suite 430
Los Angeles, CA 90095-6928

Mailing address

430 OB-GYN Consultation
200 UCLA Medical Plaza, Suite 430
Los Angeles, CA 90095-6928
Phone (310) 794-7274

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508000265 CA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 3870835077

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1670 E 120TH St
Los Angeles, CA 90059-3026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851435424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 OB-GYN CONSULTATION",
            "address_2": "200 UCLA MEDICAL PLAZA, SUITE 430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956928",
            "telephone_number": "310-794-7274",
            "fax_number": "310-794-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 OB-GYN CONSULTATION",
            "address_2": "200 UCLA MEDICAL PLAZA, SUITE 430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956928",
            "telephone_number": "310-794-7274",
            "fax_number": "310-794-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBI",
        "first_name": "SHADMAN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.