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DR. SHERVIN ALEXANDER ETEMAD MD
NPI 1972130011
General Practice in Los Angeles, CA

Active since March 26, 2020PECOS Enrolled
1510 SAN PABLO ST STE 415, LOS ANGELES, CA 90033(203) 816-1441 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 7, 2024, Nov 13, 2023, Nov 7, 2023 and 1 more (4 updates tracked since 2020).

About Dr. Shervin Alexander Etemad Md NPPES

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

DR. SHERVIN ALEXANDER ETEMAD MD (NPI 1972130011) is an individual general practice provider in Los Angeles, California, licensed in California (A189034) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972130011
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. SHERVIN ALEXANDER ETEMADCredential: MD
Location Address1510 SAN PABLO ST STE 415Los Angeles, CA 90033-5403
Mailing Address1510 San Pablo St Ste 415Los Angeles, CA 90033-5403 · (203) 816-1441
Phone(203) 816-1441
Sole ProprietorNo
Enumeration DateMarch 26, 2020
Last NPPES UpdateMay 7, 20244 updates tracked since enumeration
NPPES CertifiedNovember 13, 2023
✔ NPI 1972130011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · A189034
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1510 SAN PABLO ST STE 415, Los Angeles, CA 90033
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shervin Alexander Etemad 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 Shervin Etemad reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
5.6 mi
Health Maintenance Organization
2626 COLORADO BLVD
Los Angeles, CA 90041
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1013409044 (877) 608-0044

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

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.

BRYCE FILIP STARR MD
Student in an Organized Health Care Education/Training Program
1510 SAN PABLO ST STE 415
LOS ANGELES, CA 90033
Los Angeles County (323) 442-7903
EMILY CORRYN SLUITER
Student in an Organized Health Care Education/Training Program
1510 SAN PABLO ST STE 415
LOS ANGELES, CA 90033
Los Angeles County (323) 442-7903
DR. MAXWELL BATES JOHNSON MD, MS
Plastic Surgery
1510 SAN PABLO ST STE 415
LOS ANGELES, CA 90033
Los Angeles County (323) 442-7903
YI-TING WU PA-C
Physician Assistant
1510 SAN PABLO ST STE 415
LOS ANGELES, CA 90033
Los Angeles County (323) 442-7920

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 Shervin Etemad's NPI number?

The NPI number for Shervin Etemad is 1972130011. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Shervin Etemad located?

Shervin Etemad practices at 1510 San Pablo St Ste 415, Los Angeles, CA 90033. The listed phone number is (203) 816-1441.

What is Shervin Etemad's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Shervin Etemad enrolled in Medicare?

Yes. Shervin Etemad is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shervin Etemad's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shervin Etemad reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, 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 Shervin Etemad'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 Shervin Etemad was last updated on May 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.