Individual provider Active NPI

Shawn Rey Castellon, P.T.

  • Physical Therapist
  • Lake Elsinore, CA
National Provider Identifier
1659511368
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT17068 Issued in CA
Practice address
425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495
Phone
(951) 674-9515
Fax
(951) 674-9517
NPI assigned
Feb 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT17068 CA Primary

Addresses

Primary practice location

425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005

Other names 1

  • Ms. Shawn Rey McClain Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001751 CA Practitioner - Physical Therapist in Private Practice 9537144555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

425 Diamond Dr
Suite 101
Lake Elsinore, CA 92530-4495
Phone (951) 674-9515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT17068CAMDPhysical Therapist
17068CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 15, 2019 Accepting new patients
All Star Physical Therapy Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Choice Physical Therapy Inc PastSince Jan 29, 2023 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

425 Diamond Dr
Ste 101
Lake Elsinore, CA 92530
Phone (951) 674-9515

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

450 W Palmdale Blvd
Palmdale, CA 93551
Phone (661) 273-5333

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

32246 Clinton Keith Rd
Ste 103
Wildomar, CA 92595
Phone (951) 677-7221

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1659511368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DIAMOND DR STE 101",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304495",
            "telephone_number": "951-674-9515",
            "fax_number": "951-674-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLON",
        "first_name": "SHAWN",
        "middle_name": "REY",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-21",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT17068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "MCCLAIN",
            "middle_name": "REY",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.