Individual provider Active NPI

Shawn Maliece Mollica, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1811988157
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA022289 Issued in TX
Practice address
4358 Lockhill Selma Rd Ste 110
San Antonio, TX 78249
Phone
(210) 492-4300
Fax
(210) 492-4380
NPI assigned
Nov 4, 2005
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA022289 TX Primary

Addresses

Primary practice location

4358 Lockhill Selma Rd Ste 110
San Antonio, TX 78249

Mailing address

4358 Lockhill Selma Rd Ste 110
San Antonio, TX 78249-4167
Phone (210) 492-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080430000099 TX Practitioner - Physician Assistant 7719066968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical School at San Antonio, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rise Up Rehab, LLCGroup PAC ID 3274861497, 118 clinicians
Deerwood Family Practice, PLLCGroup PAC ID 0143351346, 3 clinicians

Practice addresses (Care Compare)

16400 Blanco Rd
San Antonio, TX 78232-1902
Phone (210) 572-4954

4358 Lockhill Selma Rd
Suite 110
San Antonio, TX 78249-4167
Phone (210) 492-4300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.06
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA022289TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Airrosti Rehab Centers, LLC Past Accepting new patients
Fred E Griffiths Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 4

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1811988157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 LOCKHILL SELMA RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494167",
            "telephone_number": "210-492-4300",
            "fax_number": "210-492-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 LOCKHILL SELMA RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78249",
            "telephone_number": "210-492-4300",
            "fax_number": "210-492-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLICA",
        "first_name": "SHAWN",
        "middle_name": "MALIECE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA022289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.