Shalaine Brooke Corbilla, DNP, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95018015 Issued in CA

Practice address

2017 1St Ave
Suite 100
San Diego, CA 92101-2033

Phone

(619) 881-4500

Fax

(619) 291-0959

NPI assigned

May 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaveh Bagheri, MD IncorporatedGroup PAC ID 8729973086, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Kaveh Bagheri, MD Incorporated

  • Specialist
  • La Mesa, CA
  • NPI 1982829800
  Medicare reassignment Care Compare group

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628899200000",
    "number": "1134577216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 CAMINO DEL RIO S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083538",
            "telephone_number": "619-881-4500",
            "fax_number": "866-886-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 1ST AVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012033",
            "telephone_number": "619-881-4500",
            "fax_number": "619-291-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBILLA",
        "first_name": "SHALAINE",
        "middle_name": "BROOKE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-30",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95078056",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95018015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Corbett
• Julia Corbett
• Kimberly Fara Corbett, PSYD, MFT
• Stephanie Lynn Corbett, CRNA
• Takisha M Corbett, PHD
• Corbin Smith DMD Dental Corp.
• Ann Corbin-Fulchiron, LCSW, CADC-II
• Dawn Michelle Corbin
• Heather Sachiko Corbin
• James Kenneth Corbin

• Primary Care Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.