NPIMap

Individual provider Active NPI

Shahram Shawn Gholami, MD

  • Urology Physician
  • San Jose, CA
National Provider Identifier
1932272804
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A65099 Issued in CA
Practice address
2460 Samaritan Dr
San Jose, CA 95124-3907
Phone
(408) 358-2030
NPI assigned
Nov 16, 2006
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A65099 CA Primary
Pediatric Urology Physician 2088P0231X A65099 CA

Addresses

Primary practice location

2460 Samaritan Dr
San Jose, CA 95124-3907

Mailing address

2460 Samaritan Dr
San Jose, CA 95124-3907
Phone (408) 358-2030

Other practice location 1

2581 Samaritan Dr
#200
San Jose, CA 95124
Phone (408) 358-2030

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.vmdoc.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000468 CA Practitioner - Urology 2062470149 Reassigns benefits to 2 organizations
Practice locations: San Jose, CA; Mountain View, CA; Los Gatos, CA

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Boston University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

2460 Samaritan Dr
San Jose, CA 95124-3907
Phone (408) 871-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
85.48 of 100Reported as group
Quality
80.12
Promoting interoperability
100
Improvement activities
40
Cost
71.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65099CAMDPharmacist
A65099CAMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC CurrentSince Mar 1, 2024 Accepting new patients
Urological Surgeons of Northern California, Inc. Urology CurrentSince Mar 1, 2009 Accepting new patients
National Ambulatory Surgery Center, LLC Current Accepting new patients
El Camino Hospital Past Accepting new patients
St. Mary's Good Samaritan Hospital, Inc. Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Health Medical Group PastSince Sep 8, 2019 Accepting new patients
O'Connor Hospital Past Accepting new patients

Locations

320 Dardanelli Ln
Ste 23B
Los Gatos, CA 95032
Phone (408) 866-2500

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

973 University Ave
Los Gatos, CA 95032
Phone (408) 278-3003

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

2460 Samaritan Dr
San Jose, CA 95124
Phone (408) 358-1911

2550 Samaritan Dr
Ste D
San Jose, CA 95124
Phone (408) 358-2666

2581 Samaritan Dr
Ste 200
San Jose, CA 95124
Phone (408) 358-2030

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sgholami7170@icare.elcaminohospital.org

Organizations & group practices 10

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 11

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1932272804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243907",
            "telephone_number": "408-358-2030",
            "fax_number": "408-358-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243907",
            "telephone_number": "408-358-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2581 Samaritan Dr",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "95124",
            "country_code": "US",
            "telephone_number": "408-358-2030",
            "fax_number": "408-358-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOLAMI",
        "first_name": "SHAHRAM",
        "middle_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A65099",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CA",
            "license": "A65099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.vmdoc.com",
            "affiliation": "N",
            "endpointDescription": "secure internet portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2460 Samaritan Dr",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951243907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.