Hamid Shidban, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

A48781 Issued in CA

Practice address

1516 San Pablo St FL 2
Los Angeles, CA 90033-5313

Phone

(323) 442-5908

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

General Surgery

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lavanda Home Health Care Agency, Inc Home health agency, Burbank, CA, CCN 058334
• Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
• Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
• California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: hamid.shidban@direct.usc.edu

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Pride Hospice Care Inc.

  • Community Based Hospice Care Agency
  • Burbank, CA
  • NPI 1447691282

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership

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.

• Shidban Dialysis Access Inc

  • Transplant Surgery Physician
  • Los Angeles, CA
  • NPI 1154197911
  Medicare reassignment NPD Authorized official
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment Care Compare group NPD
• Mendez Transplant and Urological Medical Group, Inc.

  • Specialist
  • Los Angeles, CA
  • NPI 1528154507
  NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Ahmc San Gabriel Valley Medical

  • Skilled Nursing Facility
  • San Gabriel, CA
  • NPI 1710174818
  NPD (past)
• Alta Los Angeles Hospital, Inc

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1114132685
  NPD (past)
• Cha Hollywood Medical Center, LP

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  NPD (past)
• Children'S Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)
• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  NPD (past)
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)
• Keck Medical Center of Usc

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1417554528
  NPD (past)
• Keck Medical Center of Usc

  • Rehabilitation Hospital Unit
  • Los Angeles, CA
  • NPI 1750988770
  NPD (past)

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

• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  Care Compare affiliation
• Keck Medical Center of Usc

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1013514199
  Care Compare affiliation
• Lavanda Home Health Care Agency Inc

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1245321751
  Care Compare affiliation
• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1942246111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-5908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171138",
            "country_code": "US",
            "telephone_number": "213-201-0850",
            "fax_number": "213-201-0853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIDBAN",
        "first_name": "HAMID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CA",
            "license": "A48781",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A48781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hamid.shidban@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1516 San Pablo St Fl 2",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey Shibata
• Seiji Bruce Shibata, M.D. PH.D.
• Vivian Phan Shibayama, O.D.
• Justin Shibel, ATC
• Shidban Dialysis Access Inc
• Jennifer Shieh
• Kate Yang Shieh, M.D.
• Pamela Shieh, PHARM.D.
• Perry Boryee Shieh, MD
• Shields for Families

• Vascular Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.