NPIMap

Individual provider Active NPI

Shane Sheahan

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1962858142
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A153317 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(419) 205-3144
NPI assigned
May 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A153317 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

4039 Berwick Ave
Toledo, OH 43612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618003468 CA Practitioner - Internal Medicine 4688936537 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Toledo Medical College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 5597663641, 61 clinicians
University of California IrvineGroup PAC ID 5395658181, shared by 9 NPIs, 57 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-6324

Hospital & facility affiliations

  • Care Plus Home Health Home health agency, Laguna Hills, CA, CCN 059376
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153317CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California-Irvine Single Specialty CurrentSince Jul 1, 2019 Accepting new patients
Regents of the University of California Single Specialty CurrentSince Nov 1, 2022 Accepting new patients
Regents of the University of California Single Specialty Current Accepting new patients
UC Regents Single Specialty Current Accepting new patients
UC Regents Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
UC Regents Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
Uci Medical Group Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

23961 Calle de la Magdalena
Ste 200
Laguna Hills, CA 92653
Phone (949) 238-4100

23961 Calle de la Magdalena
Ste 4
Laguna Hills, CA 92653

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 9

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 7

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1962858142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 BERWICK AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "419-205-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAHAN",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.