ELITE WOUND SPECIALIST PC
NPI 1154148997
Clinic/Center - Health Service in Van Nuys, CA
About Elite Wound Specialist Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELITE WOUND SPECIALIST PC (NPI 1154148997) is a healthcare organization registered as a health service in Van Nuys, California and active in the NPI registry since September 2024. The organization lists Shima Pezeshki, Shareholder, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elite Wound Specialist Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Elite Wound Specialist PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently 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 Elite Wound Specialist PC's NPI number?
The NPI number for Elite Wound Specialist PC is 1154148997. It was assigned to this organization in the NPPES registry on September 23, 2024.
Where is Elite Wound Specialist PC located?
Elite Wound Specialist PC is located at 14553 Delano St Ste 306, Van Nuys, CA 91411. The listed phone number is (310) 621-9038.
What is Elite Wound Specialist PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Elite Wound Specialist PC enrolled in Medicare?
Yes. Elite Wound Specialist PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Elite Wound Specialist PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Elite Wound Specialist PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Elite Wound Specialist PC was last updated on March 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.
# Elite Wound Specialist Pc · NPI 1154148997
Health Service organization in Van Nuys, California. Organization record, active in the CMS NPPES registry since September 23, 2024.
## Identity
- **NPI:** 1154148997 (Entity type: Organization)
- **Enumerated:** September 23, 2024
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Shima Pezeshki, SHAREHOLDER
## Practice location
- **Address:** 14553 DELANO ST STE 306, Van Nuys, CA 91411-2858
- **Phone:** (310) 621-9038
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1154148997) · Data from the CMS NPPES public registry.