Individual provider Active NPI

Shannon A Bertsche, PA-C, MPAS

  • Physician Assistant
  • Salinas, CA
National Provider Identifier
1629359070
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22926 Issued in CA
Practice address
1441 Constitution Blvd Building
Suite 300
Salinas, CA 93906
Phone
(831) 755-4123
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22926 CA Primary

Addresses

Primary practice location

1441 Constitution Blvd Building
Suite 300
Salinas, CA 93906

Mailing address

1441 Constitution Blvd Building 400
Suite 300
Salinas, CA 93906
Phone (402) 202-5605

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
I20131028002021 CA Practitioner - Physician Assistant 2567636236 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1596NEMDChiropractor
PA22926CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Oct 5, 2019 Accepting new patients
County of Santa Clara CurrentSince Oct 5, 2019 Accepting new patients
County of Santa Clara CurrentSince Oct 5, 2019 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

Interoperability endpoints

  • Direct secure messaging: sbertsche98310@santaclaravalley.direct-ci.net

Organizations & group practices 5

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1629359070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD BUILDING 400",
            "address_2": "SUITE 300",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93906",
            "telephone_number": "402-202-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD BUILDING",
            "address_2": "SUITE 300",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93906",
            "telephone_number": "831-755-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCHE",
        "first_name": "SHANNON",
        "middle_name": "A",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.