Shannon Shieh

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA62682 Issued in CA

Practice address

345 Riverside Ave
Rialto, CA 92376

Phone

(310) 853-2782

NPI assigned

Mar 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Stanford University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elite Family MedicineGroup PAC ID 7911369236, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17465/brand/1/csg/1/fhir/r4

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.

• Elite Family Medicine

  • Family Medicine Physician
  • Rialto, CA
  • NPI 1053003087
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1982306262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "310-853-2782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Badillo St",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917901133",
            "country_code": "US",
            "telephone_number": "626-962-5625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1911 W Glenoaks Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912014746",
            "country_code": "US",
            "telephone_number": "818-843-6640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2140 W Chapman Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928682331",
            "country_code": "US",
            "telephone_number": "714-881-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIEH",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flora Mohamed F Shafiee, DPTS
• Samir B Shah, D.D.S.
• Ravindranath Vishnu Shahane, M.D.
• Matthew Eric Shamlin, LMFT
• Ahmed Esam Shehata
• Julie Chien Shih, DDS
• Jerry Hyun Shim, D.D.S.
• Shiva Caremore Inc
• Arlene Rachell Shorter
• Shree Pharmacy Inc

• Physician Assistant in Rialto, CA
• Providers in Rialto, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.