Individual provider Active NPI

Shane M Meehan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
National Provider Identifier
1477605152
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
C134989 Issued in CA
Practice address
9295 Farnham St Ste 100
San Diego, CA 92123-1254
Phone
(858) 939-3660
NPI assigned
Jan 16, 2007
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X C134989 CA Primary

Addresses

Primary practice location

9295 Farnham St Ste 100
San Diego, CA 92123-1254

Mailing address

File 1440
Pasadena, CA 91199-1440
Phone (858) 939-3660

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329002960 CA Practitioner - Pathology 2365621000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Analytic Pathology Medical Group IncGroup PAC ID 6103714274, 20 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-4492

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 541-3400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
73.46
Improvement activities
40
Cost
73.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C134989CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Rim Pathology Medical Corporation Anatomic Pathology & Clinical Pathology CurrentSince Sep 1, 2015 Accepting new patients
Analytic Pathology Medical Group Inc. Anatomic Pathology & Clinical Pathology CurrentSince Sep 1, 2015 Accepting new patients
University of Chicago CurrentSince Jan 2, 1990 Accepting new patients
Pacific Rim Pathology Medical Corporation Anatomic Pathology & Clinical Pathology CurrentSince Sep 1, 2015 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

File 1440
Pasadena, CA 91199

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

9295 Farnham St
Ste 100
San Diego, CA 92123
Phone (858) 939-2660

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

Organizations & group practices 4

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 4

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1477605152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 1440",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911991440",
            "telephone_number": "858-939-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9295 FARNHAM ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231254",
            "telephone_number": "858-939-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "SHANE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C134989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.