Mrs Shiva Bakhtiari Ahmadi, FNP in Costa Mesa, CA

Mrs Shiva Bakhtiari Ahmadi, FNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Costa Mesa, California. Her current practice location is 3151 Airway Ave Ste G1, Costa Mesa, California. You can reach out to her office (for appointments etc.) via phone at (714) 545-5550.

Mrs Shiva Bakhtiari Ahmadi is licensed to practice in California (license number 95006733) 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 1356873715.

Contact Information

	Mrs Shiva Bakhtiari Ahmadi, FNP
	3151 Airway Ave Ste G1, Costa Mesa, CA 92626-4624
	(714) 545-5550
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Shiva Bakhtiari Ahmadi
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	3151 Airway Ave Ste G1, Costa Mesa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356873715
Provider Enumeration Date: 04/03/2017
Last Update Date: 04/24/2025

Medicare PECOS Information:

PECOS PAC ID: 1052686953
Enrollment ID: I20190216000040

Medical Identifiers

Medical identifiers for Mrs Shiva Bakhtiari Ahmadi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356873715	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
164W00000X	Licensed Practical Nurse	APN0000022322 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	22322 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	95006733 (California)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95006733 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shiva Bakhtiari Ahmadi allows following entities to bill medicare on her behalf.

Entity Name	Pacific Neuropsychiatric Specialists Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356685218 PECOS PAC ID: 3375796170 Enrollment ID: O20130103000082

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. Mrs Shiva Bakhtiari Ahmadi 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
Mrs Shiva Bakhtiari Ahmadi, FNP 19782 Macarthur Blvd Ste 300, Irvine, CA 92612-2417 Ph: (714) 545-5550	Mrs Shiva Bakhtiari Ahmadi, FNP 3151 Airway Ave Ste G1, Costa Mesa, CA 92626-4624 Ph: (714) 545-5550

Reviews and Comments

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Courtney Proctor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 601 W 19th St, Costa Mesa, CA 92627 Phone: 714-922-4100
Susan Curtin, RN,MSN,PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2045 Meyer Pl, Bldg C, Costa Mesa, CA 92627 Phone: 949-515-6730 Fax: 949-515-6727

Mrs Shiva Bakhtiari Ahmadi, FNP - Medicare Nurse Practitioner in Costa Mesa, CA