Individual provider Active NPI

Sean Christopher Shughrou, PA-C

  • Surgical Physician Assistant
  • La Jolla, CA
National Provider Identifier
1083306369
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA65344 Issued in CA
Practice address
9898 Genesee Ave
La Jolla, CA 92037-1205
Phone
(858) 626-6362
NPI assigned
May 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA65344 CA
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA65344 CA Primary

Addresses

Primary practice location

9898 Genesee Ave
La Jolla, CA 92037-1205

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 626-6362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231227003234 UT Practitioner - Physician Assistant 5496105801 Reassigns benefits to 1 organization
I20250612001820 CA Practitioner - Physician Assistant 5496105801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 633-6501

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65344CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Jun 23, 2025 Accepting new patients
Ihc Health Services, Inc. Multi-Specialty CurrentSince Jan 7, 2024 Accepting new patients
Scripps Health Multi-Specialty Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 7, 2024 Accepting new patients
Scripps Health Multi-Specialty CurrentSince Jun 23, 2025 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

9898 Genesee Ave
Fl 1
La Jolla, CA 92037
Phone (515) 707-7960

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

Organizations & group practices 7

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 2

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1083306369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-626-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9898 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-626-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUGHROU",
        "first_name": "SEAN",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65344",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA65344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.