SHIVA TAFAZOLI (FNP) – Family Nurse Practitioner, NPI 1922410117

SHIVA TAFAZOLI (FNP) is a healthcare provider. based in Evanston, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 209011295 (IL). The NPI Number for SHIVA TAFAZOLI (FNP) is 1922410117

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
SHIVA TAFAZOLI (FNP)
NPI
1922410117
Phone
(630) 560-5439
Address
1954 DEMPSTER ST
Enumeration Date
22 May 2014
Last Update Date
19 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486601220
Graduation Year
2013 (13 years ago)
PAC ID
0446571657
Group Practice PAC ID
5395098339
Professional Enrollment ID
I20150529002414
Address ID
IL625501337MO525XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:12State licenses:3Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for SHIVA TAFAZOLI (FNP)

  • 1954 DEMPSTER ST

    EVANSTON, IL 602021016

    Phone: (630) 560-5439

    Fax: (630) 701-1007

    Type: Location

  • 675 W North Ave Ste 402

    Melrose Park, IL 601601624

    Phone: (708) 486-2600

    Fax: (708) 486-2610

    Type: Location

  • 675 W NORTH AVE

    STE 402

    MELROSE PARK, IL 601601624

    Phone: (847) 235-6130

    Fax: (847) 235-6135

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2015-05-29

PECOS data refreshed: 2026-05-27

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
I20150529002414INurse PractitionerILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes1,14763$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes15550$0
G0317Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi9445$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes2523$0
99316Nursing facility discharge management, more than 30 minutes2019$0
View full utilization report →

Insurance plans in this area (ZIP 60202)

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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: 5395098339View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineMI
Nurse PractitionerGA
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantMI
Nurse PractitionerTN
Nurse PractitionerOH
Nurse PractitionerNC

Reviews

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Frequently asked questions

How is SHIVA TAFAZOLI (FNP) identified in CMS data?
CMS-hosted NPPES data lists SHIVA TAFAZOLI (FNP) with NPI 1922410117.
Can I rely on SHIVA TAFAZOLI (FNP) being an active provider?
As of the registry snapshot, SHIVA TAFAZOLI (FNP) is marked active.
What healthcare role does SHIVA TAFAZOLI (FNP) hold?
Scheduling teams often label SHIVA TAFAZOLI (FNP) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does SHIVA TAFAZOLI (FNP) serve?
SHIVA TAFAZOLI (FNP)'s listing highlights Evanston, Illinois; more addresses can appear in NPPES.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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