Individual provider Active NPI

Dalton Shevlin

  • Medical Physician Assistant
  • San Clemente, CA
National Provider Identifier
1407646839
Registry record updated Feb 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
905 Calle Amanecer Ste 115
San Clemente, CA 92673-6226
Phone
(194) 920-7360
NPI assigned
May 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

905 Calle Amanecer Ste 115
San Clemente, CA 92673-6226

Mailing address

1631 Doheny Way
Dana Point, CA 92629-5926
Phone (513) 462-1687

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
I20260323003562 CA Practitioner - Physician Assistant 1052895547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

905 Calle Amanecer
Suite 115
San Clemente, CA 92673-6226

905 Calle Amanecer
Suite 115
San Clemente, CA 92673-6249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769904000000",
    "number": "1407646839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 DOHENY WAY",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926295926",
            "telephone_number": "513-462-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 CALLE AMANECER STE 115",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736226",
            "telephone_number": "194-920-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVLIN",
        "first_name": "DALTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-08",
        "last_updated": "2026-02-01",
        "certification_date": "2026-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.