Individual provider Active NPI

Shirley Laurine Dickinson, M.D.

  • Family Medicine Physician
  • Marina, CA
National Provider Identifier
1679500565
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G56281 Issued in CA
Practice address
2930 2ND Ave Ste 200
Marina, CA 93933-6244
Phone
(831) 582-2100
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X G56281 CA
Family Medicine Physician 207Q00000X G56281 CA Primary

Addresses

Primary practice location

2930 2ND Ave Ste 200
Marina, CA 93933-6244

Mailing address

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

Other practice location 1

2 Upper Ragsdale Dr
Suite D-220
Monterey, CA 93940-5736
Phone (831) 649-7210

Other identifiers 1

IdentifierTypeStateIssuer
HSP40248FMedicaidCA

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
I20040217001100 CA Practitioner - Family PracticePractitioner - Sleep Medicine 2062307119 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G56281CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Apr 5, 2017 Accepting new patients
Plazita Medical Clinic Inc Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
1150 Main Street Inc Family Medicine Current Accepting new patients
Plazita Medical Clinic, Inc. Current Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Apr 5, 2017 Accepting new patients
Montage Medical Group CurrentSince Feb 1, 2025 Accepting new patients

Locations

2930 2nd Ave
#200
Marina, CA 93933
Phone (831) 582-2100

2930 2nd Ave
Ste 200
Marina, CA 93933
Phone (831) 532-2100

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

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

2 Upper Ragsdale Dr
Ste D220
Monterey, CA 93940
Phone (831) 649-7210

1150 Main St
Ste 3
Watsonville, CA 95076
Phone (831) 728-0551

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 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sleep Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montage Medical Group 125 clinicians

Practice addresses (Care Compare)

2930 2ND Ave
Suite 200
Marina, CA 93933-6244
Phone (831) 582-2100

Hospital & facility affiliations

  • Central Coast Vna & Hospice, Inc Home health agency, Monterey, CA, CCN 057002
  • Bridge Home Health Home health agency, Salinas, CA, CCN 559775
  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145
  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1679500565",
    "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": "2930 2ND AVE STE 200",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336244",
            "telephone_number": "831-582-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Upper Ragsdale Dr",
            "address_2": "Suite D-220",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939405736",
            "country_code": "US",
            "telephone_number": "831-649-7210",
            "fax_number": "831-649-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "SHIRLEY",
        "middle_name": "LAURINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "G56281",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G56281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40248F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.