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DR. EDWARD GRANT SHORE MD
NPI 1699846709
Family Medicine - Adult Medicine in Van Nuys, CA

Active since November 11, 2006PECOS EnrolledCLIA 05D0901439 · Waiver
15243 VANOWEN ST STE 412, VAN NUYS, CA 91405(818) 783-4800(818) 781-6644 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Edward Grant Shore Md NPPES

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

DR. EDWARD GRANT SHORE MD (NPI 1699846709) is an individual adult medicine provider in Van Nuys, California, licensed in California (G7953) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and holds a CLIA Waiver certificate valid through May 23, 2027.

NPPES Registry Identity

NPI1699846709
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameDR. EDWARD GRANT SHORECredential: MD
Location Address15243 VANOWEN ST STE 412Van Nuys, CA 91405-3662
Mailing Address4139 Camino De La CumbreSherman Oaks, CA 91423-4023 · (818) 789-7032
Phone(818) 783-4800
Fax(818) 781-6644
Sole ProprietorYes
Enumeration DateNovember 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1699846709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in CA · G7953
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
15243 VANOWEN ST STE 412, Van Nuys, CA 91405
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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)

Dr. Edward Grant Shore Md 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.

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 05D0901439

Edward G Shore, MD · Van Nuys, CA
Active · expires May 23, 2027
CLIA Number05D0901439
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorEdward G. Shore
Laboratory Phone(818) 783-4800
Laboratory LocationEdward G Shore, MD15243 Vanowen Street Suite 412, Van Nuys, CA 91405
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91405 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Edward Shore's NPI number?

The NPI number for Edward Shore is 1699846709. It was assigned to this individual provider in the NPPES registry on November 11, 2006.

Where is Edward Shore located?

Edward Shore practices at 15243 Vanowen St Ste 412, Van Nuys, CA 91405. The listed phone number is (818) 783-4800.

What is Edward Shore's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Edward Shore enrolled in Medicare?

Yes. Edward Shore is registered in the Medicare PECOS enrollment system.

Does Edward Shore hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0901439) is associated with this NPI, valid through May 23, 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 Edward Shore was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.