Individual provider Active NPI

Naura Shah, PA-C

  • Surgical Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1417388711
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-0110004310 Issued in CA
Practice address
2255 Ygnacio Valley Rd Ste B1
Walnut Creek, CA 94598-3335
Phone
(925) 945-7005
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004555RX OH
Surgical Physician Assistant 363AS0400X PA-0110004310 CA Primary
Dermatology Physician 207N00000X PA7118 MA
Physician Assistant 363A00000X C5-0001101 DE
Physician Assistant 363A00000X 0110004310 VA

Addresses

Primary practice location

2255 Ygnacio Valley Rd Ste B1
Walnut Creek, CA 94598-3335

Mailing address

526 Main St Ste 302
Acton, MA 01720-3301
Phone (978) 371-7010

Other practice location 1

128 Carnegie Row
Norwood, MA 02062-5161
Phone (781) 762-5858 ext. 6330

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
I20250812001618 CA Practitioner - Physician Assistant 4587968136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6155 Stoneridge Dr
Suite 150
Pleasanton, CA 94588-6500
Phone (925) 251-9012

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110004310VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Jul 29, 2025 Accepting new patients
Delaware Center for Digestive Care LLC Past Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

6155 Stoneridge Dr
Ste 150
Pleasanton, CA 94588
Phone (925) 251-9012

1542 N Tracy Blvd
#A
Tracy, CA 95376
Phone (209) 836-2220

632 W 11th St
Ste 219
Tracy, CA 95376
Phone (209) 832-3332

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

Interoperability endpoints

  • Direct secure messaging: nshah@apderm.emadirect.md

Organizations & group practices 3

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1417388711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST STE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-371-7010",
            "fax_number": "978-371-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE B1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983335",
            "telephone_number": "925-945-7005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Carnegie Row",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020625161",
            "country_code": "US",
            "telephone_number": "781-762-5858 x6330",
            "fax_number": "781-762-3307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004555RX",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA-0110004310",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "PA7118",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001101",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.