Individual provider Active NPI

Shaya Marie Dawson, DPT

  • Physical Therapist
  • Menlo Park, CA
National Provider Identifier
1851586697
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
68 Willow Rd
Menlo Park, CA 94025-3653
Phone
(866) 839-6979
NPI assigned
Sep 13, 2007
Last updated
Nov 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22320 MD
Physical Therapist 225100000X CA Primary

Addresses

Primary practice location

68 Willow Rd
Menlo Park, CA 94025-3653

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-2588

Other practice location 1

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-2588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180216001758 CA Practitioner - Physical Therapist in Private Practice 7214191980 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Nov 19, 2019 Accepting new patients
Mesisca Physical Therapy Inc Physical Therapist CurrentSince Jan 22, 2018 Accepting new patients
JM Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

30025 Alicia Pkwy
Laguna Niguel, CA 92677
Phone (714) 231-0169

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1851586697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-2588",
            "fax_number": "301-373-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253653",
            "telephone_number": "866-839-6979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24035 Three Notch Rd",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "MD",
            "postal_code": "206364871",
            "country_code": "US",
            "telephone_number": "301-373-2588",
            "fax_number": "301-373-4558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SHAYA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22320",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.