Individual provider Active NPI

Shaun Brian Davies, PA-C

  • Physician Assistant
  • Laguna Niguel, CA
National Provider Identifier
1902162357
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22210 Issued in CA
Practice address
30201 Golden Lantern Ste B
Laguna Niguel, CA 92677-5926
Phone
(949) 363-1788
Fax
(949) 363-1607
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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 22210 CA Primary

Addresses

Primary practice location

30201 Golden Lantern Ste B
Laguna Niguel, CA 92677-5926

Mailing address

2285 Corporate Cir
Ste 200
Henderson, NV 89074-7759
Phone (702) 360-2763

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
I20170707002298 CA Practitioner - Physician Assistant 2365748191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

30201 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5926
Phone (949) 363-1788

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc CurrentSince Jul 27, 2017 Accepting new patients

Locations

30201 Golden Lantern
Ste B
Laguna Niguel, CA 92677
Phone (949) 363-1788

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

22032 El Paseo
Ste 220
Rcho Sta Marg, CA 92688
Phone (949) 407-5184

1300 Avenida Vista Hermosa
Ste 150
San Clemente, CA 92673
Phone (949) 361-6623

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

Organizations & group practices 1

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1902162357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30201 GOLDEN LANTERN STE B",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775926",
            "telephone_number": "949-363-1788",
            "fax_number": "949-363-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "SHAUN",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.