Shivani Mehta Gopalsami, NP is a medicare enrolled "Nurse Practitioner" physician in Los Angeles, California. Her current practice location is
757 Westwood Plz, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(310) 825-6301.
Shivani Mehta Gopalsami is licensed to practice in California (license number 22683) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1497008304.
Physician's Profile
| Full Name | Shivani Mehta Gopalsami |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 757 Westwood Plz, Los Angeles, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497008304
- Provider Enumeration Date: 10/17/2012
- Last Update Date: 10/01/2025
Medicare PECOS Information:
- PECOS PAC ID: 9739468430
- Enrollment ID: I20240507001630
Medical Identifiers
Medical identifiers for Shivani Mehta Gopalsami such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1497008304 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207RH0003X | Internal Medicine - Hematology & Oncology | 22683 (California) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 22683 (California) | Secondary |
| 363L00000X | Nurse Practitioner | 22683 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shivani Mehta Gopalsami is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Shivani Mehta Gopalsami, NP 5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631 Ph: () - | Shivani Mehta Gopalsami, NP 757 Westwood Plz, Los Angeles, CA 90095-3012 Ph: (310) 825-6301 |
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