Individual provider Active NPI

Owen F Shea, M.D.

  • Anesthesiology Physician
  • San Luis Obispo, CA
National Provider Identifier
1679569628
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G77181 Issued in CA
Practice address
1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone
(805) 928-1731
Fax
(805) 349-8160
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G77181 CA Primary

Addresses

Primary practice location

1911 Johnson Ave
San Luis Obispo, CA 93401-4131

Mailing address

PO Box 6406
Santa Maria, CA 93456-6406
Phone (805) 928-1731

Other identifiers 1

IdentifierTypeStateIssuer
00G771810MedicaidCA

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
I20120117000112 CA Practitioner - Anesthesiology 2062689003 Reassigns benefits to 3 organizations
Practice locations: Jackson, CA

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, Geffen School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon M Linton MD IncGroup PAC ID 3375078884, 3 clinicians

Practice addresses (Care Compare)

768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone (209) 754-3521

Hospital & facility affiliations

  • Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77181CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists of the Central Coast Anesthesiology CurrentSince Aug 1, 1998 Accepting new patients
Amador Anesthesia Medical Group, Inc. Anesthesiology CurrentSince Dec 12, 2020 Accepting new patients
Shannon M Linton MD Inc Anesthesiology CurrentSince Oct 12, 2024 Accepting new patients

Locations

24757 Dept La Lockbox
Pasadena, CA 91185

921 Oak Park Blvd
Ste 101
Pismo Beach, CA 93449
Phone (805) 471-3353

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

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.

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1679569628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6406",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934566406",
            "telephone_number": "805-928-1731",
            "fax_number": "805-349-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014131",
            "telephone_number": "805-928-1731",
            "fax_number": "805-349-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "OWEN",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G77181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G771810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.