Individual provider Active NPI

Delia R Shanahan, NP

  • Family Nurse Practitioner
  • Redlands, CA
National Provider Identifier
1306373832
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023361 Issued in CA
Practice address
25828 Redlands Blvd Ste 102
Redlands, CA 92373-8451
Phone
(909) 558-6600
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10117 WI
Family Nurse Practitioner 363LF0000X 078207-23 NH
Family Nurse Practitioner 363LF0000X 95023361 CA Primary

Addresses

Primary practice location

25828 Redlands Blvd Ste 102
Redlands, CA 92373-8451

Mailing address

File # 54701
Los Angeles, CA 90074-4701
Phone (909) 651-4300

Other practice location 1

6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone (414) 257-8577

Other practice location 2

18 Old Etna Road
Lebanon, NH 03766
Phone (603) 650-4000

Other identifiers 3

IdentifierTypeStateIssuer
100149140MedicaidWI
1033706MedicaidVT
3113951MedicaidNH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dshanahan296657@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, 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
I20180925003604 NH Practitioner - Nurse Practitioner 0840568325 Reassigns benefits to 2 organizations
I20230104002635 CA Practitioner - Nurse Practitioner 0840568325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

25455 Barton Rd
Suite 108a
Loma Linda, CA 92354-3139
Phone (909) 558-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023361CAMDFamily Nurse Practitioner
078207-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Nurse Practitioner CurrentSince Jan 16, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 1, 2018 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

25828 Redlands Blvd
Ste 102
Redlands, CA 92373
Phone (909) 558-6856

18 Old Etna Rd
Lebanon, NH 03766
Phone (603) 650-3100

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: dshanahan585038@direct.llu.edu
  • Direct secure messaging: dshanahan296657@direct.myadvocateaurora.org
  • Direct secure messaging: delia.shanahan.p1@direct.dvch.nextgenshare.com

Organizations & group practices 11

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 1

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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1306373832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE # 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-651-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25828 REDLANDS BLVD STE 102",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738451",
            "telephone_number": "909-558-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6609 W Greenfield Ave",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532144958",
            "country_code": "US",
            "telephone_number": "414-257-8577",
            "fax_number": "414-257-8505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Old Etna Road",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "03766",
            "country_code": "US",
            "telephone_number": "603-650-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "DELIA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10117",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "078207-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100149140",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033706",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3113951",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshanahan296657@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.