Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SOROUSH VAHDATI-SHAMS PA-C
NPI 1477375491
Physician Assistant in Prospect Hill, NC

Q: What is Soroush Vahdati-shams's NPI number?

The NPI number for Soroush Vahdati-shams is 1477375491. It was assigned to this individual provider in the NPPES registry on October 30, 2024.

Q: What is Soroush Vahdati-shams's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since October 30, 2024PECOS Enrolled

322 MAIN ST, PROSPECT HILL, NC 27314(336) 562-3311 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 16, 2026, Jan 27, 2026 (2 updates tracked since 2026).

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About Soroush Vahdati-shams Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOROUSH VAHDATI-SHAMS PA-C (NPI 1477375491) is an individual physician assistant in Prospect Hill, North Carolina, licensed in North Carolina (0010-16270) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477375491

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSOROUSH VAHDATI-SHAMSCredential: PA-C

Location Address322 MAIN STProspect Hill, NC 27314-9438

Mailing Address322 Main StProspect Hill, NC 27314-9438 · (336) 562-3311 · Fax (336) 562-4444

Phone(336) 562-3311

Sole ProprietorNo

Enumeration DateOctober 30, 2024

Last NPPES UpdateJuly 16, 20262 updates tracked since enumeration

NPPES CertifiedJuly 16, 2026

✔ NPI 1477375491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-16270

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

322 MAIN ST, Prospect Hill, NC 27314

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soroush Vahdati-shams Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27314 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON FAZZOLARE PA-C

Physician Assistant