Individual provider Active NPI

Mahamaya Shenoy, MD

  • General Practice Physician
  • North Hills, CA
National Provider Identifier
1861536591
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A51777 Issued in CA
Practice address
15206 Parthenia St
North Hills, CA 91343-5305
Phone
(818) 895-3100
Fax
(818) 893-9464
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A51777 CA Primary

Addresses

Primary practice location

15206 Parthenia St
North Hills, CA 91343-5305

Mailing address

15206 Parthenia St
North Hills, CA 91343-5305
Phone (818) 895-3100

Other identifiers 4

IdentifierTypeStateIssuer
HAP70436FMedicaidCA
W11698OtherCAGROUP ID
FHC70436FMedicaidCA
EAP70436FMedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000596 CA Practitioner - General Practice 2668505231 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51777CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Oct 2, 2019 Accepting new patients
Mission City Community Network, Inc. CurrentSince Oct 2, 2019 Accepting new patients
Mission City Community Network,Inc Past Accepting new patients

Locations

15210 Parthenia St
North Hills, CA 91343
Phone (801) 895-3100

8527 Sepulveda Blvd
North Hills, CA 91343
Phone (310) 926-4865

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

15206 Parthenia St
Sepulveda, CA 91343

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1861536591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15206 PARTHENIA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435305",
            "telephone_number": "818-895-3100",
            "fax_number": "818-893-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15206 PARTHENIA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435305",
            "telephone_number": "818-895-3100",
            "fax_number": "818-893-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOY",
        "first_name": "MAHAMAYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A51777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP70436F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID",
            "identifier": "W11698",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70436F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EAP70436F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hills, CA

Sources for this page

Verify at the official NPI Registry.