Individual provider Active NPI

Shelly Rae Dawson, MD

  • Family Medicine Physician
  • Marina, CA
National Provider Identifier
1619068103
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C146662 Issued in CA
Practice address
3130 Del Monte Blvd
Marina, CA 93933-3047
Phone
(831) 883-3330
Fax
(831) 883-3335
NPI assigned
Sep 27, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101238261 VA
Family Medicine Physician 207Q00000X C146662 CA Primary

Addresses

Primary practice location

3130 Del Monte Blvd
Marina, CA 93933-3047

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

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
I20170619002040 CA Practitioner - Family Practice 7315971454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Practice addresses (Care Compare)

3130 Del Monte Blvd
Marina, CA 93933-3047
Phone (831) 883-3330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.47 of 100Reported as group
Quality
67.19
Promoting interoperability
100
Improvement activities
40
Cost
67.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C146662CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors on Duty Medical Group, Inc CurrentSince Jun 1, 2017 Accepting new patients
Culpeper Medical Associates, LLC Past Accepting new patients
Uva Culpeper Medical Center Past Accepting new patients
Rector & Visitors of the University of Virginia Past Accepting new patients

Locations

3130 Del Monte Blvd
Marina, CA 93933
Phone (831) 883-3330

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

Interoperability endpoints

  • Direct secure messaging: sdawson15187@direct.svmh.com

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619068103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 DEL MONTE BLVD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333047",
            "telephone_number": "831-883-3330",
            "fax_number": "831-883-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SHELLY",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238261",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C146662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.