Individual provider Active NPI

Taylor Dawson, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1114486453
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61138 Issued in CA
Practice address
4505 La Jolla Village Dr Ste C5
San Diego, CA 92122-1214
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Mar 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12948 MN
Physician Assistant 363A00000X 61138 CA Primary

Addresses

Primary practice location

4505 La Jolla Village Dr Ste C5
San Diego, CA 92122-1214

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taylor.dawson@nor.eclinicaldirectplus.com

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
I20220727004056 CA Practitioner - Physician Assistant 3375885734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

4505 La Jolla Village Dr
Suite C5
San Diego, CA 92122-1214
Phone (619) 232-3500

7740 El Camino Real
Suite F
Carlsbad, CA 92009-8514
Phone (619) 232-3500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61138CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
One Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
The Regents of the University of California PastSince Jul 1, 2022 Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

7740 El Camino Real
Ste F
Carlsbad, CA 92009
Phone (619) 232-3500

1230 Columbia St
Ste 100
San Diego, CA 92101
Phone (619) 232-3500

4505 La Jolla Village Dr
Ste C5
San Diego, CA 92122
Phone (619) 232-3500

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1114486453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 LA JOLLA VILLAGE DR STE C5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221214",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9825 Hospital Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694768",
            "country_code": "US",
            "telephone_number": "763-587-7900",
            "fax_number": "763-494-7501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12948",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taylor.dawson@nor.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5109 36th Ave N",
            "city": "Crystal",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554222007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.