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SHANNON POLLEY
NPI 1225608722
Physician Assistant in Chula Vista, CA

Active since June 28, 2021PECOS EnrolledAccepts Medicare Assignment
765 MEDICAL CENTER CT STE 211, CHULA VISTA, CA 91911(617) 636-0405 Get Directions Write a Review

NPPES record last updated: May 31, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Polley NPPES

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

SHANNON POLLEY (NPI 1225608722) is an individual physician assistant in Chula Vista, California, licensed in California (60864) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Tufts University School Of Medicine (2022).

NPPES Registry Identity

NPI1225608722
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHANNON POLLEY
Location Address765 MEDICAL CENTER CT STE 211Chula Vista, CA 91911-6600
Mailing Address765 Medical Center Ct Ste 211Chula Vista, CA 91911-6600
Phone(617) 636-0405
Sole ProprietorYes
Medical School CMSTufts University School Of MedicineGraduated 2022
Enumeration DateJune 28, 2021
Last NPPES UpdateMay 31, 2022
NPPES CertifiedMay 31, 2022
✔ NPI 1225608722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 60864
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
765 MEDICAL CENTER CT STE 211, Chula Vista, CA 91911
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Secondary Practice Location 1

Location 14725 Market StSan Diego, CA 92102-4715 · Phone (619) 515-2560

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Polley is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901272921
PECOS Enrollment IDI20221017001851
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91911 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
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.

MILIND DAKSHESH PARIKH D.O.
Internal Medicine (Cardiovascular Disease)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (619) 616-2100
KENDALL FRYER PA
Physician Assistant
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (616) 619-2100
ALAN KURIAKOSE JOHN M.D.
Internal Medicine (Interventional Cardiology)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (619) 616-2100
DAPHNE BINTO
Physician Assistant
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (508) 373-5820
DR. STEVEN K CARLSON
Internal Medicine (Clinical Cardiac Electrophysiology)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (310) 319-4698
DR. AKILESH HONASOGE M.D.
Internal Medicine (Interventional Cardiology)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (619) 616-2100
MANOLO RUBIO GARCIA MD
Internal Medicine (Interventional Cardiology)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (619) 616-2100
MEENA ROHINI NARAYANAN MD
Internal Medicine (Cardiovascular Disease)
765 MEDICAL CENTER CT STE 211
CHULA VISTA, CA 91911
San Diego County (619) 616-2100

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 Shannon Polley's NPI number?

The NPI number for Shannon Polley is 1225608722. It was assigned to this individual provider in the NPPES registry on June 28, 2021.

Where is Shannon Polley located?

Shannon Polley practices at 765 Medical Center Ct Ste 211, Chula Vista, CA 91911. The listed phone number is (617) 636-0405.

What is Shannon Polley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Shannon Polley enrolled in Medicare?

Yes. Shannon Polley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Shannon Polley was last updated on May 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.