Shelby Lynne Simonin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10452 Silverdale Way NW
Silverdale, WA 98383-9411

Phone

(360) 307-7300

NPI assigned

Sep 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssimonin4139723@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701

  WA

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Clinical Medical Laboratory
  • Renton, WA
  • NPI 1285805119
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • Community Based Hospice Care Agency
  • Seattle, WA
  • NPI 1437289576
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • Home Health Agency
  • Seattle, WA
  • NPI 1528198660
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1861522088
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1972774180
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1780290296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W LOMBARD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10452 SILVERDALE WAY NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839411",
            "telephone_number": "360-307-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Lombard St",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528042029",
            "country_code": "US",
            "telephone_number": "563-333-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONIN",
        "first_name": "SHELBY",
        "middle_name": "LYNNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-20",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10452 Silverdale Way NW",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983839411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Silverdale Pediatrics
• Silverdale Psychiatric Services, LLC
• Simmonds Chiropractic and Wellness Inc
• Casey J Simmonds
• Sunny Jo Simon, LMHC
• Nathan William Sims, PA-C
• Susan L Sims, HAD
• Moranda Sinclair
• Lakhwant Singh, D.O.
• Bridget Ann Singletary, CCC-SLP

• All providers in Silverdale, WA
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.