Almoutaz Bellah Shakally, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A154138 Issued in CA

Practice address

399 E Highland Ave Ste 227
San Bernardino, CA 92404-3851

Phone

(612) 616-3963

NPI assigned

Feb 26, 2009

Last updated

Nov 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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

Specialty

Endocrinology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Almoutaz Bellah Shakally MD, IncGroup PAC ID 2860818580, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score

84.09 of 100Reported as group

Quality

57.89

Improvement activities

40

Cost

75.1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Almoutaz Bellah Shakally MD, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Corona, CA
  • NPI 1821612565
  Medicare reassignment Care Compare group NPD Authorized official
• Bashar G Saad MD Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • San Dimas, CA
  • NPI 1881906568
  Medicare reassignment NPD
• Empire Endocrinology PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Corona, CA
  • NPI 1104715317
  NPD Authorized official
• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)
• Temecula Valley Hospital Inc

  dba Temecula Valley Hospital

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  NPD (past)
• Uhs Corona Inc

  dba Corona Regional Medical Center

  • Rehabilitation Hospital Unit
  • Corona, CA
  • NPI 1255327920
  NPD (past)
• Catholic Health Initiatives-Iowa Corp

  dba MercyOne Des Moines Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1861632168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 JEFFERSON AVE STE 2",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103522",
            "telephone_number": "909-882-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE STE 227",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043851",
            "telephone_number": "612-616-3963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55416",
            "country_code": "US",
            "telephone_number": "952-993-3123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5450 Jefferson Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917103522",
            "country_code": "US",
            "telephone_number": "909-882-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKALLY",
        "first_name": "ALMOUTAZ",
        "middle_name": "BELLAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "63294",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-39303",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "39303",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A154138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.