SHOHREH NOUROLLAH (PA) – Physician Assistant, NPI 1396954079

SHOHREH NOUROLLAH (PA) is a healthcare provider. based in Los angeles, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA16960 (CA). The NPI Number for SHOHREH NOUROLLAH (PA) is 1396954079

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
SHOHREH NOUROLLAH (PA)
NPI
1396954079
Phone
(310) 497-6666
Address
1741 S BEDFORD ST
Enumeration Date
21 May 2007
Last Update Date
6 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8187558000
Graduation Year
2002 (24 years ago)
PAC ID
1254505811
Group Practice PAC ID
9638082456
Professional Enrollment ID
I20111116000217
Address ID
CA916063204NX12157BLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

10,686 PHYSICIAN ASSISTANT in CA

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Provider Addresses for SHOHREH NOUROLLAH (PA)

  • 1741, South Bedford Street, Reynier Village, Pico-Robertson, Los Angeles, Los Angeles County, California, 90035, United States

    LOS ANGELES, CA 900354320

    Phone: (310) 497-6666

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $216.

Total Amount is formed as General ($216) + Research ($0) + Ownership ($0) = $216.

Last reported payment date: 2024-08-15 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($86).

Total Amount

$216

General + Research + Ownership

Payments

10

Total payment records

General Amount

$216

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-16

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111116000217IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90035)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638082456View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Physician AssistantCA
Internal MedicineCA
Family Practice, Internal MedicineCA
Physician AssistantCA
Nurse PractitionerCA
Family PracticeCA
Family PracticeCA
-CA

Reviews

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Frequently asked questions

What identifier follows SHOHREH NOUROLLAH (PA) across health systems?
The NPI 1396954079 uniquely identifies SHOHREH NOUROLLAH (PA) in U.S. healthcare data.
Is SHOHREH NOUROLLAH (PA) currently accepting referrals based on NPI status?
Registry metadata lists SHOHREH NOUROLLAH (PA) as active.
What does the directory say SHOHREH NOUROLLAH (PA) does?
Insurance directories may phrase it differently, but here SHOHREH NOUROLLAH (PA) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SHOHREH NOUROLLAH (PA)?
SHOHREH NOUROLLAH (PA) is associated with Los Angeles, California in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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