SHADI MEDICAL CORPORATION
NPI 1104997311
Clinic/Center - Urgent Care in Los Angeles, CA
About Shadi Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHADI MEDICAL CORPORATION (NPI 1104997311) is a healthcare organization registered as an urgent care in Los Angeles, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through May 18, 2027 and lists Payam Shadi, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shadi Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Shadi Medical Corporation, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D1012719
Shadi Medical Corporation · Los Angeles, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shadi Medical Corporation's NPI number?
The NPI number for Shadi Medical Corporation is 1104997311. It was assigned to this organization in the NPPES registry on November 10, 2006.
Where is Shadi Medical Corporation located?
Shadi Medical Corporation is located at 8815 W Pico Blvd, Los Angeles, CA 90035. The listed phone number is (323) 938-9999.
What is Shadi Medical Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.
Is Shadi Medical Corporation enrolled in Medicare?
Yes. Shadi Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shadi Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Shadi Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (3), Family Practice (1) and Nurse Practitioner (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shadi Medical Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D1012719) is associated with this NPI, valid through May 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Shadi Medical Corporation was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shadi Medical Corporation · NPI 1104997311
Urgent Care organization in Los Angeles, California. Organization record, active in the CMS NPPES registry since November 10, 2006.
## Identity
- **NPI:** 1104997311 (Entity type: Organization)
- **Enumerated:** November 10, 2006
- **Primary specialty:** Clinic/Center - Urgent Care · taxonomy 261QU0200X
- **Organization subpart:** No
- **Authorized official:** Payam Shadi, PRESIDENT
## Practice location
- **Address:** 8815 W PICO BLVD, Los Angeles, CA 90035-3301
- **Phone:** (323) 938-9999 · **Fax:** (323) 456-0880
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (3), Family Practice (1), Nurse Practitioner (1); 1 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2026
- **Other identifiers:** Medicaid 1104997311 (CA)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1104997311) · Data from the CMS NPPES public registry.