Individual provider Active NPI

Shelby McIlvaine, PA-C

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1053947184
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57788 Issued in CA
Practice address
280 S Main St
Orange, CA 92868-3852
Phone
(714) 634-4567
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57788 CA Primary

Addresses

Primary practice location

280 S Main St
Orange, CA 92868-3852

Mailing address

280 S Main St
Orange, CA 92868-3852
Phone (714) 634-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012002501 CA Practitioner - Physician Assistant 0749600807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16300 Sand Canyon Ave
Suite 511
Irvine, CA 92618-3705
Phone (714) 634-4567

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.34 of 100Reported as group
Quality
48.62
Promoting interoperability
94
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57788CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: shelby.harrisonpac.p1@direct.osiortho.nextgenshare.com
  • Direct secure messaging: shelby.harrisonpac.p2@direct.osiortho.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1053947184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683852",
            "telephone_number": "714-634-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683852",
            "telephone_number": "714-634-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVAINE",
        "first_name": "SHELBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.