Individual provider Active NPI

Crystal Shen, PA-C

  • Physician Assistant
  • Encinitas, CA
National Provider Identifier
1336858323
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61934 Issued in CA
Practice address
326 Santa Fe Dr
Encinitas, CA 92024-5156
Phone
(760) 633-7032
NPI assigned
Nov 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61934 CA Primary

Addresses

Primary practice location

326 Santa Fe Dr
Encinitas, CA 92024-5156

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 633-7032

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
I20221216001752 CA Practitioner - Physician Assistant 2961871793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

10862 Calle Verde
La Mesa, CA 91941-7340
Phone (619) 670-5400

278 Town Ctr Pkwy
Suite 105
Santee, CA 92071-5809
Phone (619) 713-7880

3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone (858) 764-3000

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61934CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Jan 2, 2023 Accepting new patients
Scripps Health Physician Assistant Current Accepting new patients
Scripps Health CurrentSince Jan 2, 2023 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

326 Santa Fe Dr
Fl 3
Encinitas, CA 92024
Phone (760) 633-6067

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Organizations & group practices 5

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 3

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1336858323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-633-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 SANTA FE DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245156",
            "telephone_number": "760-633-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.