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ELAINE SHAN M.D.
NPI 1053767434
Pediatrics in Sacramento, CA

Active since May 04, 2016PECOS Enrolled
3234 MARYSVILLE BLVD, SACRAMENTO, CA 95815(918) 407-2495 Get Directions Write a Review

NPPES record last updated: June 12, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 12, 2020, Jun 17, 2019 (2 updates tracked since 2019).

About Elaine Shan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELAINE SHAN M.D. (NPI 1053767434) is an individual pediatrics provider in Sacramento, California, licensed in California (A168601) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1053767434
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameELAINE SHANCredential: M.D.
Location Address3234 MARYSVILLE BLVDSacramento, CA 95815-1411
Mailing Address1860 Howe Ave Ste 455Sacramento, CA 95825-1086 · (918) 407-2495
Phone(918) 407-2495
Sole ProprietorNo
Enumeration DateMay 4, 2016
Last NPPES UpdateJune 12, 20202 updates tracked since enumeration
NPPES CertifiedJune 12, 2020
✔ NPI 1053767434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in CA · A168601✔ Licensed in AZ · 58623✔ Licensed in AZ · R75544
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3234 MARYSVILLE BLVD, Sacramento, CA 95815
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11501 N Campbell Ave Rm 3301Tucson, AZ 85724-0001 · Phone (520) 626-7944 · Fax (520) 626-5652
Location 2155 Calle Portal Ste 700Sierra Vista, AZ 85635 · Phone (520) 459-0203

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elaine Shan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Elaine Shan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Elica Health Centers
Same address
Federally Qualified Health Center (FQHC)
3234 MARYSVILLE BLVD
Sacramento, CA 95815
  • Reassigned Medicare billing, California enrollment
  • 91 clinicians in this Medicare group
NPI 1346784295 (916) 454-2345

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95815 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DMITRIY VLADIMIROVICH BAZARON CNP
Nurse Practitioner
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 454-2345
MS. CINDA LEE TEJERAS LCSW
Social Worker
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 646-1200
HALIFU OSAMURE PRINCE
Counselor
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 454-2345
ANDREW DAVID BOWMAN MD
Pediatrics
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 454-2345
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA
Family Medicine
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 646-1200
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA
Non-Pharmacy Dispensing Site
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 646-1200
ELICA HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 454-2345
BIRTH AND FAMILY HEALTH CENTER
Clinic/Center (Family Planning, Non-Surgical)
3234 MARYSVILLE BLVD
SACRAMENTO, CA 95815
Sacramento County (916) 646-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elaine Shan's NPI number?

The NPI number for Elaine Shan is 1053767434. It was assigned to this individual provider in the NPPES registry on May 4, 2016.

Where is Elaine Shan located?

Elaine Shan practices at 3234 Marysville Blvd, Sacramento, CA 95815. The listed phone number is (918) 407-2495.

What is Elaine Shan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Elaine Shan enrolled in Medicare?

Yes. Elaine Shan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elaine Shan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elaine Shan reassigns Medicare benefits to Elica Health Centers (Sacramento, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elaine Shan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Elaine Shan was last updated on June 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.