Individual provider Active NPI

Sean Lo

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1750137378
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
874 American Pacific Dr
Henderson, NV 89014-8800
Phone
(702) 777-8687
NPI assigned
Apr 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65610 CA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

874 American Pacific Dr
Henderson, NV 89014-8800

Mailing address

19337 Phil LN
Cupertino, CA 95014-3429

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
I20250701003334 CA Practitioner - Physician Assistant 5395258438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65610CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jun 10, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Interoperability endpoints

  • Direct secure messaging: slo740805@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1750137378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19337 PHIL LN",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 AMERICAN PACIFIC DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148800",
            "telephone_number": "702-777-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-25",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65610",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.