Individual provider Active NPI

Shaun Thomas O'Malley, PA-C

  • Physician Assistant
  • Montrose, CO
National Provider Identifier
1649932146
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1010 S Rio Grande Ave
Montrose, CO 81401-4831
Phone
(970) 497-3333
Fax
(855) 299-7837
NPI assigned
Oct 12, 2021
Last updated
May 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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 NU Primary

Addresses

Primary practice location

1010 S Rio Grande Ave
Montrose, CO 81401-4831

Mailing address

1010 S Rio Grande Ave
Montrose, CO 81401-4831
Phone (970) 497-3333

Other practice location 1

87 Merchant Dr
Montrose, CO 81401-3015
Phone (970) 252-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250212003904 CO Practitioner - Physician Assistant 3870023336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marillac Clinic, Inc.Group PAC ID 1052634748, 19 clinicians

Practice addresses (Care Compare)

510 29
Grand Junction, CO 81504-5383
Phone (979) 200-1600

526 29
Grand Junction, CO 81504

526 29
Grand Junction, CO 81504-5383
Phone (970) 200-1600

87 Merchant Dr
Montrose, CO 81401-3015
Phone (970) 200-1600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1710760343 CurrentSince Dec 6, 2024 Accepting new patients
Marillac Clinic, Inc. Dba Primehealth Physician Assistant Past Accepting new patients
Marillac Clinic, Inc. Dba Primehealth PastSince May 7, 2024 Accepting new patients
Marillac Clinic, Inc Dba Primehealth Past Accepting new patients

Locations

2333 N 6th St
Grand Junction, CO 81501
Phone (970) 298-1782

87 Merchant Dr
Montrose, CO 81401
Phone (970) 252-8896

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 2

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1649932146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S RIO GRANDE AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014831",
            "telephone_number": "970-497-3333",
            "fax_number": "855-299-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S RIO GRANDE AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014831",
            "telephone_number": "970-497-3333",
            "fax_number": "855-299-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 Merchant Dr",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814013015",
            "country_code": "US",
            "telephone_number": "970-252-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "SHAUN",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.