Individual provider Active NPI

Shelley Anne Baella, PA-C

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1669808549
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22786 Issued in CA
Practice address
31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone
(951) 316-4621
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 PA22786 CA Primary

Addresses

Primary practice location

31700 Temecula Pkwy
Temecula, CA 92592-5896

Mailing address

10203 Glen Ivy Rd
Corona, CA 92883-5185
Phone (951) 316-4621

Other names 1

  • Shelley Anne Campbell-Baella Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140124001220 CA Practitioner - Physician Assistant 6002044864 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

6640 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6650 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6670 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Orange County - Anaheim Hospital, Anaheim, CA, CCN 050609

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22786CAMDChiropractor
PA22786CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 3, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 3, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 3, 2019 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 6

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1669808549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 GLEN IVY RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928835185",
            "telephone_number": "951-316-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896",
            "telephone_number": "951-316-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAELLA",
        "first_name": "SHELLEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "CAMPBELL-BAELLA",
            "middle_name": "ANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.