Organization Active NPI

Shahrzad Shareghi MD PC

  • Cardiovascular Disease Physician
  • Thousand Oaks, CA
National Provider Identifier
1912322728
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SHAHRZAD SHAREGHI MD PC
Practice address
235 N Conejo School Rd Apt 110
Thousand Oaks, CA 91362-2675
Phone
(646) 245-5415
NPI assigned
Mar 3, 2014
Last updated
Mar 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Dr. Shahrzad Shareghi, MDNPI 1811176720
Title
President
Phone
(646) 245-5415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

235 N Conejo School Rd Apt 110
Thousand Oaks, CA 91362-2675

Mailing address

2220 Lynn Rd Ste 208
Thousand Oaks, CA 91360-8042
Phone (646) 245-5415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140424001806 CA Part B Supplier - Clinic/Group Practice 0547493637 Receives reassigned benefits from 1 practitioner
Practice locations: Simi Valley, CA; Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

2876 Sycamore Dr
Ste 202
Simi Valley, CA 93065
Phone (805) 222-4757

2220 Lynn Rd
Ste 208
Thousand Oaks, CA 91360
Phone (805) 480-2600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1912322728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD STE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608042",
            "telephone_number": "646-245-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N CONEJO SCHOOL RD APT 110",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913622675",
            "telephone_number": "646-245-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRZAD SHAREGHI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "SHAREGHI",
        "authorized_official_first_name": "SHAHRZAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-245-5415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.