Individual provider Active NPI

Shatira Wilson, MD

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1558865865
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
125.072394 Issued in IL
Practice address
757 Westwood PLZ Ste 3304
Los Angeles, CA 90095
Phone
(310) 267-8653
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A176169 CA
Anesthesiology Physician 207L00000X 125.072394 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

757 Westwood PLZ Ste 3304
Los Angeles, CA 90095

Mailing address

757 Westwood PLZ Ste 3304
Los Angeles, CA 90095-8358
Phone (310) 267-8653

Other practice location 1

251 E Huron St
Chicago, IL 60611
Phone (312) 926-2000

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
I20230922002028 CA Practitioner - Anesthesiology 2466798376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Howard University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
California Anesthesia Associates Medical Group IncGroup PAC ID 8426047721, 62 clinicians

Practice addresses (Care Compare)

26357 McBean Pkwy
Suite 100
Santa Clarita, CA 91355-4489
Phone (661) 799-8300

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-5437

2880 Atlantic Ave
Suite 160
Long Beach, CA 90806-1715
Phone (562) 453-3814

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176169CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 1, 2025 Accepting new patients
California Anesthesia Associates Medical Group, Inc. Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 1, 2025 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients

Locations

24451 Health Center Dr
#104
Laguna Hills, CA 92653

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2801 Atlantic Ave
Ste Lbmm
Long Beach, CA 90806

2880 Atlantic Ave
Ste 160
Long Beach, CA 90806
Phone (562) 453-3814

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

26357 McBean Pkwy
Ste 100
Valencia, CA 91355
Phone (661) 799-8300

Interoperability endpoints

  • Direct secure messaging: swilson806553@direct.memorialcare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1558865865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 3304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-267-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 3304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-267-8653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHATIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A176169",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125.072394",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.