DR. SHARIAR COHEN-GADOL M.D.
NPI 1013054865
Internal Medicine - Rheumatology in Thousand Oaks, CA


Quality Rating: 80.57 out of 100 score

NPI Status: Active since January 31, 2007

Contact Information

566 SAINT CHARLES DR
THOUSAND OAKS, CA
ZIP 91360
Phone: (805) 449-8781
Fax: (805) 449-4224

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  • Individual
  • Male
  • Years of Experience 24
  • Internal Medicine
  • Rheumatology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 05D2313704
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-04-2026

About SHARIAR COHEN-GADOL

This page provides the complete NPI Profile along with additional information for Shariar Cohen-gadol, an internist established in Thousand Oaks, California with a medical specialization in Internal Medicine, focusing in rheumatology and more than 24 years of experience. The healthcare provider is registered in the NPI registry with number 1013054865 assigned on January 2007. The practitioner's primary taxonomy code is 207RR0500X with license number A88619 (CA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1013054865
Provider Name
DR. SHARIAR COHEN-GADOL M.D.
Gender
Male
Entity Type
Individual
Location Address
566 SAINT CHARLES DR THOUSAND OAKS, CA 91360
Location Phone
(805) 449-8781
Location Fax
(805) 449-4224
Mailing Address
566 SAINT CHARLES DR THOUSAND OAKS, CA 91360
Mailing Phone
(805) 449-8781
Mailing Fax
(805) 449-4224
Medical School Name
OTHER
Graduation Year
2002
Is Sole Proprietor?
Yes
Enumeration Date
01-31-2007
Last Update Date
08-12-2021
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An internist like Shariar Cohen-gadol is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Rheumatology

Taxonomy Code
207RR0500X
Type
Allopathic & Osteopathic Physicians
License No.
A88619
License State
CA
Taxonomy Description
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM1200XAmbulatory Health Care Facilities

Clinic/Center
Magnetic Resonance Imaging (MRI)

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A88619OTHER (01)CAMEDICAL LICENSE

Medicare Participation & PECOS Enrollment Status

Shariar Cohen-gadol is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Shariar Cohen-gadol is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 547360463

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20070706000478

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Unknown

  • Treatment-Injections and Infusions (nononcologic) (RI008N)

    Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg (HCPCS:J1561)

    1 DME suppliers used 13 Medicare Claims 520 Services Paid

  • Treatment-Chemotherapy (RH012N)

    Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration (HCPCS:Q2052)

    1 DME suppliers used 13 Medicare Claims 13 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 1,110 times for 192 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 814 times for 73 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

This service was performed 1,012 times for 154 patients

Aspiration and/or injection of fluid from medium joint using ultrasound guidance

This is a procedure where a needle is guided by ultrasound into a medium-sized joint, like a knee or shoulder. The needle can be used to remove fluid, which can relieve pressure and pain, or to inject medication to help with inflammation and discomfort.

This service was performed 28 times for 22 patients

Aspiration and/or injection of fluid from small joint

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

This service was performed 71 times for 37 patients

Aspiration and/or injection of fluid from small joint using ultrasound guidance

This procedure involves using ultrasound to accurately locate a small joint. A needle is then carefully inserted to remove fluid (aspiration) or inject medication. This can help diagnose or treat joint issues. It's generally safe and minimally invasive.

This service was performed 97 times for 62 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 935 times for 310 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

This service was performed 30 times for 30 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 80 times for 67 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 53 times for 25 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 541 times for 358 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 2,953 times for 1,286 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 1,196 times for 717 patients

Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose

Hyaluronan or Euflexxa is a substance similar to a natural substance in your joints. It's injected into the joint space to treat pain from osteoarthritis, especially in the knee. It helps to lubricate the joint, reducing pain and improving mobility.

This service was performed 159 times for 30 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

This service was performed 285 times for 126 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 158 times for 46 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 14 times for 14 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 961 times for 119 patients

Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve)

This procedure involves injecting an anesthetic or steroid into the lower back and leg nerve to alleviate pain. The injection helps reduce inflammation and numb the area, providing relief from discomfort. This is a common treatment for conditions such as sciatica and herniated discs.

This service was performed 19 times for 13 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 2,689 times for 829 patients

Injection of trigger points, 3 or more muscles

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

This service was performed 38 times for 24 patients

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.

This service was performed 15,500 times for 22 patients

Injection, ceftriaxone sodium, per 250 mg

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

This service was performed 105 times for 11 patients

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.

This service was performed 169,200 times for 55 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 46,440 times for 449 patients

Injection, diphenhydramine hcl, up to 50 mg

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

This service was performed 339 times for 63 patients

Injection, golimumab, 1 mg, for intravenous use

Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

This service was performed 60,500 times for 82 patients

Injection, infliximab, excludes biosimilar, 10 mg

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

This service was performed 4,036 times for 15 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

This service was performed 2,357 times for 298 patients

Injection, methylprednisolone acetate, 20 mg

Methylprednisolone acetate is a medication given via injection to reduce inflammation and pain. It's often used to treat conditions like arthritis, allergic reactions, and certain skin diseases. The 20 mg dose is tailored to your specific needs.

This service was performed 101 times for 69 patients

Injection, methylprednisolone acetate, 40 mg

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

This service was performed 274 times for 136 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 776 times for 388 patients

Injection, methylprednisolone sodium succinate, up to 125 mg

Methylprednisolone sodium succinate is a steroid medication injected into a muscle or vein. It helps reduce inflammation and immune response. It's used for various conditions like allergies, arthritis, breathing problems, or skin diseases. It's important to follow your doctor's instructions.

This service was performed 648 times for 99 patients

Injection, ondansetron hydrochloride, per 1 mg

Ondansetron hydrochloride is a medication given via injection to help prevent nausea and vomiting, often due to chemotherapy or surgery. It works by blocking certain chemicals in the body that trigger these symptoms.

This service was performed 1,357 times for 22 patients

Injection, rituximab, 10 mg

Rituximab is a medication given via injection. It's used to treat certain types of cancer and autoimmune diseases. The 10 mg dosage refers to the amount of the drug in the injection. It works by targeting and destroying specific cells, helping your body's immune system.

This service was performed 14,050 times for 38 patients

Injection, romosozumab-aqqg, 1 mg

Romosozumab-aqqg is a medication given by injection to treat osteoporosis in patients at high risk for fractures. It works by increasing bone mass and strength, reducing the risk of fractures.

This service was performed 132,510 times for 145 patients

Injection, tocilizumab, 1 mg

Tocilizumab is a medication administered via injection. It's used to treat certain conditions like rheumatoid arthritis by reducing inflammation in the body. It works by blocking a substance in the body that leads to inflammation.

This service was performed 64,960 times for 18 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 160 times for 16 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 82 times for 55 patients

Injection, zoledronic acid, 1 mg

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

This service was performed 150 times for 30 patients

Methotrexate sodium, 5 mg

Methotrexate sodium, 5 mg, is a medication often used to treat certain types of cancer or control severe psoriasis or rheumatoid arthritis. It works by slowing the growth of cancer cells and suppressing the immune system. Always follow your doctor's instructions when taking this medication.

This service was performed 138 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 318 times for 318 patients

Ultrasonic guidance for needle placement

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

This service was performed 33 times for 26 patients

X-ray of ankle, minimum of 3 views

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

This service was performed 153 times for 84 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 61 times for 57 patients

X-ray of elbow, minimum of 3 views

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

This service was performed 19 times for 14 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 190 times for 106 patients

X-ray of hand, minimum of 3 views

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

This service was performed 389 times for 199 patients

X-ray of knee, 3 views

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

This service was performed 321 times for 173 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 92 times for 92 patients

X-ray of middle spine, 2 views

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

This service was performed 21 times for 21 patients

X-ray of pelvis, minimum of 3 views

An X-ray of the pelvis with a minimum of 3 views is a diagnostic procedure that uses radiation to create images of your lower body area. This helps in detecting issues like fractures, arthritis, or other abnormalities. It's quick, non-invasive, and typically painless.

This service was performed 96 times for 96 patients

X-ray of shoulder, minimum of 2 views

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

This service was performed 144 times for 89 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 88 times for 87 patients

X-ray of wrist, minimum of 3 views

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

This service was performed 292 times for 150 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $35.18 for a new patient copayment and $27.18 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 91360 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $140.72
  • Minimum New Patient Price $62.32
  • Maximum New Patient Price $185.36
  • Average New Patient Copayment $35.18
  • Minimum New Patient Copayment $15.58
  • Maximum New Patient Copayment $46.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $108.74
  • Minimum Established Patient Price $20.68
  • Maximum Established Patient Price $151.85
  • Average Established Patient Copayment $27.18
  • Minimum Established Patient Copayment $5.17
  • Maximum Established Patient Copayment $37.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 80.57, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: .

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 80.57 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 35.26

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 35.26

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Advance Care Plan 100% 1795
Controlling High Blood Pressure 98% 327
Documentation of Current Medications in the Medical Record 100% 10640
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 3374
Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity 100% 718
Screening for Osteoporosis for Women Aged 65-85 Years of Age 100% 417
Tuberculosis Screening Prior to First Course of Biologic and/or Immune Response Modifier Therapy 100% 201

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2313704
Facility Type
Physician Office
Certificate Effective Date
November 05, 2024
Certificate Expiration Date
November 04, 2026
Laboratory Director
SHARIAR COHEN-GADOL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Shariar Cohen-gadol to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1013054865, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
4
Doubled → 8
Pos 8
8
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 4 → 8 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 0 + 5 + 8 + 8 + 1 + 2 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1013054865.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Internal Medicine (Rheumatology)
566 SAINT CHARLES DR
THOUSAND OAKS, CA 91360
Internal Medicine (Rheumatology)
566 SAINT CHARLES DR
THOUSAND OAKS, CA 91360

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013054865, enumerated as an "individual" on January 31, 2007.

The provider is located at 566 SAINT CHARLES DR THOUSAND OAKS, CA 91360 and the phone number is (805) 449-8781.

Internal Medicine with taxonomy code 207RR0500X and a focus in Rheumatology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.