Individual provider Active NPI

Shadi Shamsi, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1366277352
Registry record updated Sep 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65009 Issued in CA
Practice address
13145 Calle de Los Ninos
San Diego, CA 92129-2919
Phone
(858) 437-1480
NPI assigned
Sep 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2024

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 PA65009 CA Primary

Addresses

Primary practice location

13145 Calle de Los Ninos
San Diego, CA 92129-2919

Mailing address

13145 Calle de Los Ninos
San Diego, CA 92129-2919
Phone (858) 437-1480

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
I20241114001530 CA Practitioner - Physician Assistant 8820522774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

10538 Mission Gorge Rd
Suite 100
Santee, CA 92071-3154
Phone (619) 456-0033

750 Otay Lakes Rd
Suite 272
Chula Vista, CA 91910-6915

760 Otay Lakes Rd
Chula Vista, CA 91910-6915
Phone (619) 821-2300

8260 Mira Mesa Blvd
Suite a
San Diego, CA 92126-2662
Phone (858) 900-3550

8590 Rio San Diego Dr
Suite 111
San Diego, CA 92108-5597
Phone (619) 736-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65009CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Somagen Healthcare Inc CurrentSince Nov 7, 2024 Accepting new patients
Somagen Healthcare Inc CurrentSince Nov 7, 2024 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients

Locations

760 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 821-2300

750 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 259-9462

5671 Balboa Ave
San Diego, CA 92111
Phone (855) 362-9773

1740 Rosecrans St
San Diego, CA 92106
Phone (619) 790-7800

8590 Rio San Diego Dr
Ste 111
San Diego, CA 92108
Phone (619) 736-4600

8260 Mira Mesa Blvd
Ste A
San Diego, CA 92126
Phone (855) 362-9773

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1366277352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13145 CALLE DE LOS NINOS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292919",
            "telephone_number": "858-437-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13145 CALLE DE LOS NINOS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292919",
            "telephone_number": "858-437-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMSI",
        "first_name": "SHADI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.