NPIMap

Individual provider Active NPI

Shawn M Brubaker, DO

  • Orthopaedic Surgery Physician
  • Redding, CA
National Provider Identifier
1356473078
Registry record updated Sep 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20A9922 Issued in CA
Practice address
2510 Airpark Dr
Ste 301
Redding, CA 96001-2449
Phone
(530) 242-3500
Fax
(530) 242-3546
NPI assigned
Mar 9, 2007
Last updated
Sep 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 20A9922 CA Primary

Addresses

Primary practice location

2510 Airpark Dr
Ste 301
Redding, CA 96001-2449

Mailing address

3400 Data Dr
Physician Support Services, 2ND Floor
Rancho Cordova, CA 95670-7956

Other identifiers 4

IdentifierTypeStateIssuer
0116018251OtherVAVIRGINIA MEDICAL LICENSE
SL0399OtherNVNEVADA MEDICAL LICENSE
20A9922OtherCACA MEDICAL LICENSE
5101015098OtherMIMICHIGAN MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080108000589 CA Practitioner - Orthopedic Surgery 5395825921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

2510 Airpark Dr
Suite 301
Redding, CA 96001-2462
Phone (530) 242-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement100
Knee replacement196
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9922CAMDOrthopaedic Surgery Physician
9922CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jul 31, 2012 Accepting new patients
Shasta Regional Medical Center, LLC Past Accepting new patients
William K. Borgsmiller M.D. P.C. Past Accepting new patients
Catholic Healthcare West Past Accepting new patients
Dignity Health Past Accepting new patients
Shasta Orthopedics & Sports Medicine a Medical Corporation Orthopaedic Surgery PastSince Aug 15, 2004 Accepting new patients
Apogee Outpatient Surgery Center Past Accepting new patients

Locations

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

2528 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 528-6100

2580 Sister Mary Columba Dr
Ste 200
Red Bluff, CA 96080
Phone (530) 528-6150

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411776000000",
    "number": "1356473078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES, 2ND FLOOR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "STE 301",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012449",
            "telephone_number": "530-242-3500",
            "fax_number": "530-242-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "SHAWN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAL LICENSE",
            "identifier": "0116018251",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA MEDICAL LICENSE",
            "identifier": "SL0399",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "20A9922",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN MEDICAL LICENSE",
            "identifier": "5101015098",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.