Individual provider Active NPI

Jamie Shen

  • Physical Therapist
  • El Cajon, CA
National Provider Identifier
1194460782
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301818 Issued in CA
Practice address
522 Jamacha Rd
El Cajon, CA 92019-2448
Phone
(907) 947-3394
NPI assigned
Apr 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 301818 CA Primary

Addresses

Primary practice location

522 Jamacha Rd
El Cajon, CA 92019-2448

Mailing address

9709 Mesa Springs Way
San Diego, CA 92126-4145
Phone (907) 947-3394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000582 CA Practitioner - Physical Therapist in Private Practice 0244608974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians
Nexus Physical TherapyGroup PAC ID 6305890609, 9 clinicians

Practice addresses (Care Compare)

10243 Genetic Ctr Dr
San Diego, CA 92121-6310
Phone (858) 499-2600

12411 Poway Rd
Suite 202B
Poway, CA 92064-4302
Phone (858) 312-6444

3200 4TH Ave
Suite 100
San Diego, CA 92103-5716
Phone (619) 297-4404

522 Jamacha Rd
El Cajon, CA 92019-2448
Phone (619) 579-1625

5353 Mission Ctr Rd
Suite 120
San Diego, CA 92108-1304
Phone (619) 497-2836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nexus Physical Therapy Physical Therapist CurrentSince Jul 2, 2022 Accepting new patients

Locations

1310 3rd Ave
Chula Vista, CA 91911
Phone (619) 420-0869

522 Jamacha Rd
El Cajon, CA 92019
Phone (619) 579-1625

15835 Pomerado Rd
Ste 101
Poway, CA 92064
Phone (858) 312-6444

3200 4th Ave
Ste 100
San Diego, CA 92103
Phone (619) 293-3994

3191 Sports Arena Blvd
Ste B
San Diego, CA 92110
Phone (619) 226-4131

2970 5th Ave
Ste 220
San Diego, CA 92103
Phone (619) 297-4404

Organizations & group practices 2

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": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1194460782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 MESA SPRINGS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264145",
            "telephone_number": "907-947-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 JAMACHA RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192448",
            "telephone_number": "907-947-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.