Individual provider Active NPI

Shelley B. Kirby, PA-C

  • Medical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1962706341
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21394 Issued in CA
Practice address
3301 C St Ste 550
Sacramento, CA 95816-3386
Phone
(916) 733-2900
Fax
(916) 733-2996
NPI assigned
Dec 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21394 CA Primary

Addresses

Primary practice location

3301 C St Ste 550
Sacramento, CA 95816-3386

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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
I20110314000130 CA Practitioner - Physician Assistant 7911187026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1561 Creekside Dr
Folsom, CA 95630-3495

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 560-0319

3301 C St
Suite 500
Sacramento, CA 95816-3372
Phone (916) 556-3300

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21394CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Jun 21, 2021 Accepting new patients
Dignity Health Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

1561 Creekside Dr
Ste 170
Folsom, CA 95630
Phone (916) 351-4825

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3301 C St
Ste 550
Sacramento, CA 95816
Phone (916) 556-3200

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1962706341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 C ST STE 550",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163386",
            "telephone_number": "916-733-2900",
            "fax_number": "916-733-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "SHELLEY",
        "middle_name": "B.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.