Individual provider Active NPI

Shahriare Nasser-Moaddeli, M.D.

  • Nephrology Physician
  • Whittier, CA
National Provider Identifier
1902811391
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A51518 Issued in CA
Practice address
12462 Putnam St.
Suite 506
Whittier, CA 90602-1002
Phone
(562) 698-8141
Fax
(562) 698-9885
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A51518 CA
Nephrology Physician 207RN0300X A51518 CA Primary

Addresses

Primary practice location

12462 Putnam St.
Suite 506
Whittier, CA 90602-1002

Mailing address

P.O. Box 511
Whittier, CA 90608-0511
Phone (562) 698-8141

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
I20100120000849 CA Practitioner - NephrologyPractitioner - Internal Medicine 8426088568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12462 Putnam St
Suite 506
Whittier, CA 90602-1049
Phone (562) 698-8141

Hospital & facility affiliations

  • RC Home Healthcare Inc Home health agency, Upland, CA, CCN 058342
  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169
  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393
  • Socal Post-Acute Care Nursing home, Whittier, CA, CCN 055168

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intercommunity Dialysis Services CurrentSince Jul 22, 2022 Accepting new patients
Intercommunity Dialysis Center-la Mirada CurrentSince Mar 28, 2018 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1902811391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 511",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906080511",
            "telephone_number": "562-698-8141",
            "fax_number": "562-698-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 PUTNAM ST.",
            "address_2": "SUITE 506",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021002",
            "telephone_number": "562-698-8141",
            "fax_number": "562-698-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSER-MOADDELI",
        "first_name": "SHAHRIARE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51518",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A51518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.