Individual provider Active NPI

Shawn K. Brady, MD

  • Emergency Medicine Physician
  • Jackson, CA
National Provider Identifier
1811000573
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A52057 Issued in CA
Practice address
200 Mission Boulevard
Jackson, CA 95642-2564
Phone
(209) 223-7500
NPI assigned
Aug 16, 2006
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A52057 CA Primary

Addresses

Primary practice location

200 Mission Boulevard
Jackson, CA 95642-2564

Mailing address

P.O. Box 11949
Westminster, CA 92685-1949
Phone (800) 513-5332

Other identifiers 1

IdentifierTypeStateIssuer
00A520570MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050124000040 LA Practitioner - Family PracticePractitioner - Emergency Medicine 8628028131 Reassigns benefits to 2 organizations
I20051230000230 CA Practitioner - Emergency MedicinePractitioner - Family Practice 8628028131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

200 Mission Blvd
Jackson, CA 95642-2564
Phone (209) 223-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.7
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52057CAMDEmergency Medicine Physician
52057CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
East Baton Rouge Emergency Physicians Group, LLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
C & M Medical Services, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Amador Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients
Tuolumne General Medical Associates Emergency Medicine Past Accepting new patients
Regional Radiological Associates, Inc. a Medical Group Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3223 8th St
Ste A
Metairie, LA 70002

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

Interoperability endpoints

  • Direct secure messaging: sbrady216795@hisp.ehr.sutterhealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1811000573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 11949",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926851949",
            "telephone_number": "800-513-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MISSION BOULEVARD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422564",
            "telephone_number": "209-223-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "SHAWN",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A52057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A520570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

Verify at the official NPI Registry.