Individual provider Active NPI

Sheldon King Sloan, PA-C

  • Medical Physician Assistant
  • Lakeport, CA
National Provider Identifier
1285607259
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
925 Bevins CT
Lakeport, CA 95453-9754
Phone
(707) 253-8382
Fax
(707) 263-1909
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 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 PA19539 CA
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

925 Bevins CT
Lakeport, CA 95453-9754

Mailing address

PO Box 1950
Lakeport, CA 95453-1950
Phone (707) 263-8382

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
I20080225000313 CA Practitioner - Physician Assistant 0648354068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

925 Bevins CT
Lakeport, CA 95453-9754
Phone 70726383821204

Hospital & facility affiliations

  • Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329
  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA19539CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Tribal Health Consortium Inc. CurrentSince Oct 3, 2017 Accepting new patients

Locations

925 Bevins Ct
Lakeport, CA 95453
Phone (707) 263-8382

Interoperability endpoints

  • Direct secure messaging: sheldon.sloan.p1@direct.lcthc.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 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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1285607259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531950",
            "telephone_number": "707-263-8382",
            "fax_number": "707-263-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BEVINS CT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-253-8382",
            "fax_number": "707-263-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "SHELDON",
        "middle_name": "KING",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19539",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.