Individual provider Active NPI

Sheila Michelle Thares-Callaway, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cupertino, CA
National Provider Identifier
1316032501
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP10654 Issued in CA
Practice address
19000 Homestead
Cupertino, CA 95014
Phone
(408) 366-4200
Fax
(408) 366-4201
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP10654 CA Primary

Addresses

Primary practice location

19000 Homestead
Cupertino, CA 95014

Mailing address

2512 Samaritan Drive
Suite M
San Jose, CA 95129-1341
Phone (408) 358-3715

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20110808000280 CA Practitioner - Nurse Practitioner 0840469987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP10654CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince May 31, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince May 31, 2011 Accepting new patients

Locations

19000 Homestead Rd
Cupertino, CA 95014
Phone (408) 366-4200

1800 Harrison St
Fl 7
Oakland, CA 94612

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

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.

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1316032501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 SAMARITAN DRIVE",
            "address_2": "SUITE M",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951291341",
            "telephone_number": "408-358-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 HOMESTEAD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "95014",
            "telephone_number": "408-366-4200",
            "fax_number": "408-366-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARES-CALLAWAY",
        "first_name": "SHEILA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP10654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "19000 Homestead Rd",
            "city": "Cupertino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950140712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.