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SHALA RAHBAR FARDIN MD
NPI 1720114432
Dermatology in Sausalito, CA

Active since February 26, 2007PECOS Enrolled
96.96/100
CMS Quality Rating
2330 MARINSHIP WAY STE 370, SAUSALITO, CA 94965(415) 887-9758(415) 887-9763 Get Directions Write a Review

NPPES record last updated: September 24, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shala Rahbar Fardin Md NPPES

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

SHALA RAHBAR FARDIN MD (NPI 1720114432) is an individual dermatology provider in Sausalito, California, licensed in California (A98841) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720114432
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameSHALA RAHBAR FARDINCredential: MD
Location Address2330 MARINSHIP WAY STE 370Sausalito, CA 94965-2853
Mailing Address2330 Marinship Way Ste 370Sausalito, CA 94965-2853 · (415) 887-9758 · Fax (415) 887-9763
Phone(415) 887-9758
Fax(415) 887-9763
Sole ProprietorNo
Enumeration DateFebruary 26, 2007
Last NPPES UpdateSeptember 24, 2013
✔ NPI 1720114432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Licenses✔ Licensed in CA · A98841✔ Licensed in MA · P-230971
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2330 MARINSHIP WAY STE 370, Sausalito, CA 94965
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Other Names 1

Former Name (1)Shala Rahbar Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shala Rahbar Fardin 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.

Medicare Billing Reassignment

Medicare enrollment records show Shala Fardin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern Marin Dermatology, Inc.
Same address
Dermatology
2330 MARINSHIP WAY, SUITE 370
Sausalito, CA 94965
  • Reassigned Medicare billing, California enrollment
  • 7 clinicians in this Medicare group
NPI 1487090924 (415) 887-9758

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94965 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
$104.67 typical visit price
range $69.07 – $202.63
Typical copayment $26.16 (range $17.26 – $50.65)
Most-billed visit code 99203
Established Patient
$85.00 typical visit price
range $23.44 – $166.64
Typical copayment $21.25 (range $5.86 – $41.66)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.96/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.93
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

STEPHANIE G CULLINANE PA C
Physician Assistant
2330 MARINSHIP WAY STE 370
SAUSALITO, CA 94965
Marin County (415) 887-9758
HOLLY LOUISE CHRISTMAN M.D.
Dermatology (MOHS-Micrographic Surgery)
2330 MARINSHIP WAY STE 370
SAUSALITO, CA 94965
Marin County (415) 887-9758
MS. ELISABETH G CAIN PA-C
Physician Assistant
2330 MARINSHIP WAY STE 370
SAUSALITO, CA 94965
Marin County (415) 887-9758
DR. SUZANNE L WESTPHAL MD
Dermatology
2330 MARINSHIP WAY STE 370
SAUSALITO, CA 94965
Marin County (415) 887-9758

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 Shala Fardin's NPI number?

The NPI number for Shala Fardin is 1720114432. It was assigned to this individual provider in the NPPES registry on February 26, 2007. The provider is also known as Shala Rahbar MD.

Where is Shala Fardin located?

Shala Fardin practices at 2330 Marinship Way Ste 370, Sausalito, CA 94965. The listed phone number is (415) 887-9758.

What is Shala Fardin's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Shala Fardin enrolled in Medicare?

Yes. Shala Fardin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shala Fardin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shala Fardin reassigns Medicare benefits to Southern Marin Dermatology, Inc. (Sausalito, CA). The 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 Shala Fardin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shala Fardin was last updated on September 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.