Individual provider Active NPI

Shada Abubaker

  • Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1891419552
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95022127 Issued in CA
Practice address
1250 N Bellflower Blvd
Long Beach, CA 90840-0004
Phone
(562) 985-4463
NPI assigned
Sep 27, 2022
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95022127 CA Primary

Addresses

Primary practice location

1250 N Bellflower Blvd
Long Beach, CA 90840-0004

Mailing address

1250 N Bellflower Blvd
Long Beach, CA 90840-0004

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
I20241115001376 CA Practitioner - Nurse Practitioner 6709310550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
BLDG 41
Newport Beach, CA 92663-4162
Phone (949) 764-4060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95022127CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Sep 5, 2024 Accepting new patients

Locations

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

1 Hoag Dr
Bldg 41
Newport Beach, CA 92663
Phone (949) 764-4060

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1891419552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908400004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908400004",
            "telephone_number": "562-985-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUBAKER",
        "first_name": "SHADA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.